Practicing Psychotherapy

in Constructed Reality
Practicing Psychotherapy
in Constructed Reality
Ritual, Charisma, and
Enhanced Client Outcomes

Stephen Bacon

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Names: Bacon, Stephen, author.
Title: Practicing psychotherapy in constructed reality : ritual, charism, and enhanced
client outcomes / Stephen Bacon.
Description: Lanham : Lexington Books, [2018] | Includes bibliographical references
and index.
Identifiers: LCCN 2018005356 (print) | LCCN 2018004078 (ebook) |
ISBN 9781498552271 (electronic) | ISBN 9781498552264 (cloth : alk. paper)
Subjects: | MESH: Psychotherapy | Psychotherapy—education | Treatment Outcome |
Professional-Patient Relations
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 Contents

Acknowledgmentsvii

Introduction: Real versus Constructed 1

PART I: THE NEW THERAPEUTIC MILIEU 15
1 Psychology’s Inconvenient Truths 17
2 Close Encounters with the Abyss 45
3 Social Constructionism 63
4 A Place to Stand 103
5 The Nomological Net 117
PART II: ENHANCING THERAPIST EFFECTIVENESS 129
6 Focus on the Therapist 131
7 Beginner’s Mind 139
8 Wizards among Us 167
9 Apollonian Power: The Primacy of the Conscious Mind 191
10 Identity211
11 Heart and Soul 229
12 The Other Royal Road: Social Determinants of Change 257
13 Dionysian Power: Sacred Space and Altered States 275
14 The Spiritual Path 303

v
vi Contents

15 Becoming Remarkable 343

16 The Way Forward  385

Appendix: The Geography of Constructed Reality 391

References395
Index405
About the Author 409
 Acknowledgments

This book challenges many of the basic assumptions of psychology and psy-
chotherapy. In particular, it argues against the inherent power of techniques
and systems of thought and recommends replacing a scientific psychology
with one that operates in constructed reality. Because these ideas contradict
so much within established psychological thought, it has been necessary to
tap into fields and expertise that lie outside psychology.
Fortunately my life choices exposed me to a substantial amount of such extra-
psychological philosophies. I am particularly grateful to the teachers and compan-
ions I encountered while living in a Yoga ashram in the 1970s; they introduced
me to the concept of the perennial philosophy—a central organizing factor in this
book. My professors in religious studies at the University of Colorado continued
this education; many of the central thinkers quoted herein come from courses I
took in Boulder. My work with Outward Bound—and the spirited, thoughtful,
and compassionate instructors I met there—impressed me with the importance
of charisma and the ability to cultivate it though adventurous experiences. The
workshops I was privileged to attend—particularly the ones with strategic family
systems and Ericksonian focuses—pushed me further down the path.
This book benefited from conversations with and feedback from many
people. I particularly want to express my gratitude to David Burger, who has
been on this journey with me from the beginning, and Kjell Rudestam, a local
psychologist who made especially useful suggestions. I also want to thank my
fifteen-year-old son Aidan. He kept asking questions about what I was writ-
ing, which was lovely in itself, but it also required me to frequently reframe
complicated ideas into a more accessible form.
Finally, as we are all aware, none of this book would have been possible
without the contributions and experience of hundreds of clients who have
always been my best teachers.

vii
 Introduction
Real versus Constructed

A thought, even a possibility, can shatter and transform us.

­—Friedrich Nietzsche, The Complete Works
of Friedrich Nietzsche (1911)

I first thought of writing this book in 1978 as an undergraduate student. I was

completing a double major in religious studies and psychology and one of my
religious studies professors assigned a paper on social constructionism. As I
wrote my paper on a constructionist perspective on spiritual practice it was
impossible not to imagine where such concepts might fit into my other great
interest: clinical psychology.
This was, of course, prior to all the good work done by thought leaders
such as Kenneth Gergen and the narrative therapy school so I had a kind of
fresh look at the whole perspective. It was clear to me that psychology hadn’t
really taken the time to integrate these ideas into its foundational theories.
And that seemed strange to me because the briefest of analyses suggests that
psychotherapy operates primarily in constructed reality.
I was sympathetic to clinical psychology’s attempts to function as a sci-
entific discipline and, indeed, when I went on to get my doctorate, my major
was clinical psychology but my minor was in statistics. I used to tell my
friends that after all the hours spent in clinical offices—where everything
was ephemeral and could change in a moment depending on the frame and
reframe—it was a relief to study statistics where there was a relatively clear
sense of right and wrong. Actually, I was joking. I loved the fluidity and
spontaneity of the clinical process and found myself stimulated by the ease
with which a client’s reality—or my own—could turn on a simple phrase or
a meaningful experience.

1
2 Introduction

Over time, as my career developed and I had the chance to study with dif-
ferent mentors, work in a variety of settings, and meet hundreds of clients and
families, I never really abandoned my sense that under all of the diagnoses,
case conceptualizations, and techniques was the raw, unformed material of
reality. Sure we could freeze it temporarily with our constructions and our
social validations, but the discerning ear could always hear a background
rumbling—the presence of chaos and generativity and the always-looming
Abyss. More important than simply sensing this underlying presence, my
mind was beginning to explore ideas about the new clinical approaches that
constructionism might offer.
Thanks to a variety of prescient thinkers, social constructionism is no
longer a stranger to clinical psychology and has been integrated in a vari-
ety of ways. With all that, psychology continues to ignore just how central
constructionism is to its processes and our basic assumptions remain firmly
committed to the concept that psychotherapy operates in fundamental reality.
Given that choice, the door remains shut in terms of fully engaging with the
new possibilities implicit in a constructionist frame.
Fortunately, clinical psychology’s own research shows the incongru-
ences and contradictions in that assumption; when reexamined carefully,
this research provides substantial support for a constructionist perspective.
However, sorting out the assumptions from the deductions requires a bit of
careful detective work.
Psychology has done thousands of studies to determine if psychotherapy
works and why it works. The conclusions of this research are typically pre-
sented simply and directly: psychotherapy is effective. Its success rests on
potent techniques. We are continuing our search for more efficient and pow-
erful ways to help people change.
These statements seem quite clear. However, scattered throughout these
studies are a series of clues that actually point toward a different set of con-
clusions. When we follow the clues, we find that what seems apparent is
actually shrouded in mystery; and, like the famed “purloined letter,” much of
the mystery is hidden in plain sight.
The best starting point is the seminal study conducted by Strupp and
­Hadley; in 1979 they published research showing that “understanding” col-
lege professors were able to achieve the same level of therapeutic effective-
ness as highly experienced therapists when doing therapy with neurotics. The
implications of the study are remarkable and somewhat disheartening for
psychology. Essentially the results support the argument that therapist train-
ing and experience fail to enhance therapist efficacy.
It can be more interesting, however, to pursue some of the subtler impli-
cations of the study. Imagine that this study is replicated but, this time, the
performance of the college professors is compared to auto mechanics and the
 Introduction 3

goal is to rebuild an engine. Clearly the mechanics would be vastly superior

to the college professors; in fact, if it were a sporting event, the results would
be scored 100–0 in favor of the mechanics. The same lopsided results would
occur if the study was replicated with cardiologists and the task is to install a
pacemaker. Again the results would be cardiologists 100, college professors 0.
The reason we can be confident of these results without actually run-
ning the experiment is because we know that the professions of cardiology
and auto mechanics depend on the acquisition and possession of privileged
knowledge. Privileged knowledge is the specialized knowledge and tech-
niques required to practice the profession. Without training, practice, and
experience in the area of privileged knowledge, the tasks of the profession
cannot be accomplished. In this sense, the Strupp study went beyond a simple
critique of the importance of training and experience; essentially it argued
that psychotherapy is a field that operates without privileged knowledge.
In professions where there is something to learn, there is an overwhelm-
ingly strong training effect. The lack of any training effect in psychotherapy
implies that psychology has nothing to teach in terms of enhancing therapist
efficacy.
There is a second interesting implication that comes out of the Strupp
study. Recall that the study found that the neurotic clients significantly
improved whether they were treated by the licensed professionals or the pro-
fessors. The “score” of the study was not 0–0 but rather 100–100. Somehow,
without knowing any psychological techniques, the professors were able to
invent their own, on the spot and in the moment. And since the different
professors operated independently, they invented different techniques; in a
sense, it was like twenty different “schools of therapy” being created spon-
taneously. Apparently, as long as these different techniques were seen as
credible by the clients, they worked as well as the professionally developed
and validated techniques used by the licensed therapists. Virtually everything
worked! This suggests another important difference between psychotherapy
and cardiology/auto mechanics. In the latter there is only one right answer—
or perhaps only a few right answers—and many wrong ways to do things. In
psychotherapy—the field without privileged knowledge—there appears to be
an infinite number of right ways to operate. And, it is certainly possible that
there are no wrong answers.
Was the Strupp study an outlier or did subsequent research replicate its
findings? Unfortunately for psychology, the study was not only replicated,
other studies pushed its findings even further. In short, while the research
documents that therapy regularly achieves a modest positive effect, it also
shows that training and experience fail to improve that outcome. Although it
is hard to believe, the new life coach, who has taken two weekend workshops,
essentially achieves the same results as a PhD scholar with twenty years of
4 Introduction

experience. Moreover, all the research on client characteristics has also failed
to improve outcome. Knowing the typical behaviors of alcoholics, or the
stages of grief, or the results of trauma should allow the therapist to be more
effective; unfortunately, they do not. Finally, all the books written about all
the psychotherapeutic systems—behavioral, psychodynamic, family systems,
and so forth—have also failed to improve therapeutic outcomes one bit. In
sum, virtually all the research, all the training, all the techniques, and all the
theoretical approaches have essentially failed to advance therapeutic efficacy
in any measurable way. It appears as if psychology’s century-long quest to
establish a solid base of privileged knowledge has failed.
This takes us to the next important research finding: the so-called dodo
bird conclusion. This conclusion, which comes from the Alice in Wonderland
quote “Everyone has won and all must have prizes” (Carroll, 1869, p. 34)
refers to the finding that all the systems in psychology achieve equivalent
positive results. Studies that apparently show the superiority of one school
over another—for example, the superiority of psychodynamic therapy over
cognitive behavioral therapy—are either due to random chance, experimen-
tal design flaws, or, most importantly, allegiance effects. Allegiance effects
occur when the experimenter or the treating therapists are personally aligned
with one treatment versus the comparison treatment. The dodo bird finding is
so robust, and has been replicated so frequently, that one prominent outcome
research expert, Bruce Wampold, has actually recommended against further
treatment outcome research given that the inevitable result will be: both are
effective and neither is more effective than the other.
Frankly, the dodo bird conclusion contradicts common sense. We know
that the different schools of therapy use radically different techniques and
think about pathology and change from entirely dissimilar perspectives. Is
it really probable that they would achieve exactly the same positive effect?
From a common sense perspective such a conclusion seems highly unlikely.
The other conclusion—that techniques and underlying philosophies add noth-
ing to therapist efficacy—seems just as unlikely. Something happens in the
room and it appears to be a technique. If you ask a typical client, they will
report something like, “I was depressed and then I learned CBT tools and
got better.” Or, “I had OCD and the therapist used hypnosis to reduce my
compulsions.” From such recitations, it appears that the techniques used with
clients have independent power and the improvement in client symptoms is
due to the efficacy of the techniques.
Regardless of the seeming power of techniques, we already know that
they are not the source of change. If techniques had inherent power, then
experienced therapists would best the untrained since they know validated
techniques. And, of course, the dodo bird conclusion requires us to believe
that the differing techniques have exactly the same power—a conclusion that
 Introduction 5

is hard to swallow. In sum, in spite of clients and therapists having the feel-
ing that techniques are responsible for change, the research suggests that the
active factor lies elsewhere.
Psychology’s primary response to the dodo bird conclusion was the devel-
opment of common factor theory. This theory postulates that clients change
due to a combination of common factors—usually described as a relationship
with a wise and caring therapist—and specific factors—techniques and their
underlying systems of thought. While the research has essentially demon-
strated that the effect size of techniques/specific factors is zero, the field is in
denial about these results and continues to hope for a major role for specific
factors. In other words, psychology cannot let go of the sense that techniques
are the basis of change in spite of the research conclusions. In addition to this
feeling that change is due to techniques, there is an additional payoff—if we
can find specific factors, then we will have privileged knowledge and can join
the other professions who operate on that basis. Hope springs eternal.
Regardless of this clinging to hope for specific factor effects, just about
everyone agrees that an effective therapeutic relationship is important for
client change. In fact, it is not uncommon to hear therapists assert that they
have long believed that “it’s all about the relationship.” While it is certainly
credible to say that the relationship is very important, there are problems
with attributing all clinical change to the relationship. The simplest argu-
ment comes from the research on the general effectiveness of psychotherapy.
We know that psychotherapy is effective; the average treated client is better
off than 80 percent of the untreated comparison group. Now, it is clear that
many of the untreated have caring relationships with a wise friend or family
member. In other words, they have experienced the essence of the therapeutic
relationship prior to therapy and this relationship, by itself, does not result
in the same positive effect size as formal psychotherapy. The full benefits
of psychotherapy appear to require a relationship with an individual who is
formally designated as a “healer.”
Jerome Frank offers a theory to explain this discrepancy; he points out that
the expectations for change are much greater if one receives treatment from a
legitimate professional rather than simply having a conversation with a caring
and wise friend. Frank goes further and suggests that maximizing change also
requires a credible theory about why the client is suffering and a rationale
explaining how undergoing the therapeutic procedure will result in improve-
ment. Significantly, he suggests what occurs in the room is more accurately
described as a ritual instead of a technique.
Frank’s theory integrates all of the major factors revealed by the research
results. The Strupp study and the dodo bird conclusion both suggest that
virtually anything credible works in terms of helping clients change. Frank
accepts that level of fluidity and explicitly defines what makes the interaction
6 Introduction

credible: the good relationship, the explanation of the problem, and the
rationale for the ritual. He explains why the therapeutic experience results
in change in spite of the fact that techniques have no inherent power. And
his redefinition of what happens in the room—from a technique to a ritual—
sustains our feelings about the central importance of that interaction. Finally,
Frank’s theory explains why psychotherapy can be effective without privi-
leged information; if you appear to be a legitimate healer, and you have a
good relationship, and you can get the client to endorse your perspective,
virtually anything you propose will work.
Contrast his explanation with psychology’s insistence that it has privileged
information and inherently powerful techniques that are highly effective at
treating specific disorders. Certainly it is understandable to want clinical
psychology to be a “scientific” discipline with replicable results that occur
independent of practitioner or client. However, when our research results
contradict such assumptions, it is incumbent on psychology to seek alterna-
tive explanations.
We can take some comfort in the thought that our profession does not face
this dilemma alone. Certain other fields—for example, leadership, education,
and politics—have the same characteristics. In all of these fields, the beginner
can equal the performance of the expert. In addition, much as these fields have
tried, they have no privileged knowledge equivalent to the knowledge base of
cardiology or auto mechanics. This leads to the obvious question: what makes
psychotherapy and leadership different than cardiology and auto mechanics?
Fortunately, postmodern philosophy offers a credible explanation.
At the risk of vast oversimplification, postmodernists argue that there are
two types of reality: fundamental reality and socially constructed reality. We
are all familiar with the concept of fundamental reality. A broken leg and
the way to treat it is the same across all cultures. How to build a suspension
bridge does not vary depending on whether you are a medieval prince or an
Aztec at the time of Cortes. Fundamental reality exists free from social con-
structions and is discovered.
Conversely, most of human culture is created and operates in constructed
reality. While there are often some connections to fundamental reality, human
culture, the definition of self, values, attitudes toward what is good and bad,
and meaning are essentially “made up.” As a concrete example, the definition
of femininity or honor might vary significantly from culture to culture. More
relevantly, psychological feelings and experiences are also constructed; for
example, romantic love, individuation, and psychological mindedness are
central in our culture and may hardly exist in another culture. In this sense,
each different culture creates its own social reality. However, this constructed
reality feels “discovered and true” not an “arbitrarily invented creation” pri-
marily because all other cultural members accept the same reality and live it
 Introduction 7

to each other. This way in which a constructed view of reality acquires social
support is the “social” part in social constructionism.
Like the Jerome Frank theory, constructionism fits well with the research
results. In constructed reality, anything that the therapist makes up will work
as long as he secures validation from the client. When everything works,
techniques can have no independent power. Invent any new system of psy-
chotherapy, if it is credible in our culture, you will soon generate results
equivalent to extant systems. Invent new diagnostic categories as well. If you
act confidently, you will soon find clients who endorse the new diagnosis as
an explanation for what ails them. There are no limits on diagnostic catego-
ries, effective treatments, and brand new systems of therapy.
Psychology attempts to make sense of this fluidity by using the tools of
science but science breaks down when independent observers fail to mea-
sure the same object and when the data change from client to client and
from experimenter to experimenter. Science, of course, assumes we are
operating in Reality A—fundamental reality—when in fact we are in Reality
B—constructed reality. We seek for powerful techniques and keep trying to
accumulate privileged information when such seeking is doomed to failure.
Our quest is reminiscent of the old story about the search for the keys.

One dark night, Nazrudin the Mullah was on his hands and knees under a lamp
searching for something. A group of his neighbors came over to see what was
happening.
“What have you lost, Nazrudin?” said one of his neighbors.
“My door key,” replied the Mullah.
The others got down on their hands and knees and searched for the key. After
a long unsuccessful search, one said: “We’ve looked everywhere. Are you sure
you dropped it here?”
Nazrudin looked him in the eye and answered: “Of course I didn't drop it
here. I dropped it outside my door.”
“Then why are you looking for it here!” One snapped.
“Obviously,” he said, “Because there’s more light here.” (Shah, 1996, p. 9)

If we are not going to look “where there is more light,” where might we
look? Once we have understood that we are in constructed reality and there
are no techniques with inherent power and no system that can encompass
the chaotic and unstructured nature of constructed reality, we are left with
only one option: the therapist. We know that therapists vary in their ability
to achieve positive clinical outcomes; some therapists are simply better than
others. If this superiority is not due to absorbing privileged information, nor
is it due to using powerful techniques, then it must arise secondary to the
charisma of the therapist. Charisma, as we use it here, refers to the therapist’s
ability to embody wisdom and compassion.
8 Introduction

In constructed reality, each individual must be initiated into the culture;

they must be taught how the culture structures reality. Much of this comes
from encounters with other member of the culture; each interaction includes
verbal and nonverbal elements that socially validate the shared reality. In
addition to these everyday encounters, some members of the culture are
relatively more influential than others. Such key figures—parents, teachers,
mentors, and leaders—are individuals that we defer to in terms of defining
collective reality and in terms of defining who I am and my place in the
culture.
Therapists must aspire to be seen as a key figure by the client, at least in the
arena of mental health. Accepting that therapy occurs in constructed reality
implies that the path to becoming a superior therapist rests on accumulating
more charisma so that one is recognized as a key individual. Therapy is a rit-
ual that is guided—or at the least, co-created—by the therapist. Each step of
the ritual requires the therapist to invest the moment with meaning, purpose,
and validity. Superior outcomes in therapy depend on the capacity to be seen
as a key individual—all of it rests on the willingness of the client to accept
the guidance of the therapist. Put simply, enhancing therapeutic outcomes is
essentially an attempt to enhance one’s therapeutic charisma.
At this point, the detective story discussed in the beginning comes to a con-
clusion. The research results have identified a flaw in psychology’s strategies
to enhance therapeutic outcomes. As long as we are confusing fundamental
and constructed realities, we will continue to put our efforts into a fruitless
quest for techniques, schools of therapy, and diagnostic categories that will
fail to advance the field. Leaving behind those strategies, and replacing them
with an effort to understand the nature of constructed reality is a better road.
Understanding constructed reality opens new doors in terms of the develop-
ment of therapeutic charisma.
While the detective story is completed, the purloined letter aspect of that
story remains unresolved. The purloined letter reference implies that some-
thing can be hidden in plain sight. In this sense, it should be reiterated that
all of the research findings discussed above are well known in the field. It is
a small step from the lack of training effects, no privileged information, and
the dodo bird conclusion to the realization that psychological techniques have
no inherent power.
However, from our continued use of old and failed strategies, it is clear
that psychology is in complete denial of the research results. The outcome
research should have provoked a profound reexamination of basic assump-
tions; instead, the field has essentially responded to this provocative set of
findings by ignoring them. And isn’t it remarkable that the lack of privileged
information—after almost a century of attempting to accumulate specialized
knowledge—wouldn’t be recognized for what it is: a sign that we are pursuing
 Introduction 9

a dead end? Instead, books on techniques and manualized approaches to ther-

apy continue to be published in droves; new systems of therapy are advanced
regularly; and virtually every study recommends “further research” as if more
research will solve the dilemma.
Psychology prides itself on being the research-driven field in the behav-
ioral sciences. Yet, in this case, that commitment to taking research seriously
has been abandoned. There is a phrase in psychiatry that applies: la belle
indifference. Taken from French, la belle indifference refers to an absence
of concern about a serious problem. Typically la belle indifference is gener-
ated when accepting reality would cause great psychic discomfort or when
it might require a massive shift in worldview or self-perception. Psychology
clearly has la belle indifference about the research results. Sir Arthur Conan
Doyle and Sherlock Holmes comment.

Gregory (Scotland Yard detective): “Is there any other point to which you would
wish to draw my attention?”
Holmes: “To the curious incident of the dog in the night-time.”
Gregory: “The dog did nothing in the night-time.”
Holmes: “That was the curious incident.” (Doyle, 2000, Kindle Locations
9523–9527)

As Holmes points out, this non-event—the abandonment of our responsibility

to take the research seriously—is an important clue. It has not occurred because
psychologists are less bright than other professions, nor is it due to unethical
self-interest. Rather, the cause arises out of one of the chief characteristics of
constructed reality: confusion about what is real and what is constructed.
The fact that much of reality is constructed has been understood by philos-
ophers and spiritual thinkers for thousands of years. While it has been more
openly discussed in Eastern philosophy than in the West, this knowledge
that our values, beliefs, and cultural truths are constructed has always been
limited to the few. In fact, it is sometimes called the “secret knowledge,” not
because it has been hidden so carefully but because it is difficult to absorb and
integrate into one’s life. It has also been called “maya” or illusion because
there is a sense that humans are virtually “in a trance” when it comes to suc-
cessfully discerning between the constructed and the fundamental. Accept-
ing constructionism always calls into question the validity of core cultural
beliefs; questioning such beliefs leaves the individual potentially confused,
adrift, alone, and frightened. Constructionism always takes its adherents to
the edge of the Abyss.
Psychology’s denial, therefore, is partially due to the need for collective
affirmation of Western culture and in part due to fear of the Abyss. The
tendency to confound fundamental reality and constructed reality is what
10 Introduction

supports every culture. The non-event discussed by Sherlock Holmes is the

defining characteristic of this confounding. The denial of psychology—the
ability to ignore the research and the confirming evidence inherent in the lack
of privileged information—could not happen unless psychologists feel that
accepting these simple, logical arguments threatens not only core cultural
beliefs but also personal faith in a predictable sense of reality.
I recently had a lunch experience that illustrated these principles. I was
attending a CE workshop and joined three psychologist friends at the lunch
break. They politely asked me to describe my new book. I responded by dis-
cussing Strupp, the dodo bird conclusion, the powerlessness of techniques,
the absence of privileged information, and the way in which psychotherapy
operates in constructed reality. The first psychologist responded with, “I
accept the logic of your points and cannot find a way to refute the arguments
you have made. However, your conclusions simply feel wrong to me.” The
second psychologist continued, “I don’t accept the Dodo Bird conclusion. My
review of the research shows that CBT is vastly superior to other systems.”
When I replied that the inability of psychology to show training and experi-
ence effects—and no privileged knowledge—suggests that his argument was
flawed, he responded, “The CBT effects are so well documented that you can
be sued if you fail to use those techniques and you may end up losing your
license.” The third psychologist then responded with, “I’ve long been con-
vinced that we operate in constructed reality. I’ve never heard of this idea of
privileged information and find it interesting and convincing. I look forward
to reading your book.” This lunchtime conversation illustrates the range of
responses to exposure to the “secret knowledge.” The first psychologist sim-
ply ignored the results because they felt wrong; the second rejected the results
because the implicit conflict with his worldview created fear and aggression;
and the third psychologist, who had already walked most of the way down the
path, found the discussion interesting and intriguing. In sum, it is harder to deal
with the idea of constructed reality than one might imagine, particularly when
it implications are focused in the area of your expertise and your livelihood.
These beliefs are so fundamental and pervasive—they feel so natural and
correct—that most of us fail to identify them as assumptions. There is a well-
known story that illustrates this point.

There are these two young fish swimming along, and they happen to meet an
older fish swimming the other way, who nods at them and says, “Morning, boys,
how’s the water?” And the two young fish swim on for a bit, and then eventually
one of them looks over at the other and goes, “What the hell is water?”

In psychology, “water” refers to the assumption that we simply “know” that

all of our reality is fundamental, true, solid, and real; none of our reality is
 Introduction 11

constructed, fluid, ephemeral, and relative. This assumption is so primal and

basic that it is difficult to identify when it is operating. Making “water” spe-
cific to psychology, it refers to the assumptions that psychology is a science,
that techniques have inherent power, that we have already made a great deal
of progress, that we are moving in the right direction as a field, and that we are
headed for an eventual outcome where we understand pathology, the capac-
ity to change, and the way to treat mental illness. These assumptions feel
true. As the lunchtime conversation illustrated, the alternative “feels” wrong.
Of course, as psychologists attempting to advance our field we are required to
bring our assumptions into conscious awareness. However, fully releasing all
of these invalid assumptions can be harder than one might imagine.
This is a book about enhancing therapist efficacy. Unfortunately the
research shows that reading books is generally unhelpful in terms of meeting
this goal. Moreover, any new book that wishes to make a contribution must
be written without a dependence on techniques; techniques are the “great red
herring” of books on training therapists. If you take the research seriously,
you have to overcome these obstacles.
As might be anticipated, I hope to get around the “ineffectiveness of
books” finding by embracing social constructionism; it can be argued that
previous books are impotent because they confuse fundamental reality with
constructed reality and because they believe in the inherent power of tech-
niques. Second, I intend to focus on the therapist; scientific psychology—
which has an implicit commitment to developing techniques that can be used
by any trained therapist—tends to neglect the therapist factor. Finally, con-
structionism includes a strong focus on the client; the client’s validation of
every proposed ritual is necessary for meaningful transformation and change.
But before we can really discuss how to enhance therapist charisma, we
have to agree what “water” is. Without that agreement, we can’t talk about
solutions to the training/experience/technique dilemma. Even worse, until
we understand why we don’t even know we are swimming in water—that is,
until we understand the impact of our hidden assumptions—we won’t even
know the right questions to ask.
Lest this seem somewhat overwhelming or, even worse, an exercise in
philosophical abstractions, we are rescued by a number of common sense fac-
tors. First, postmodern concepts have been taught in universities for at least
half a century; most college graduates and many members of the culture are
familiar with the basic ideas and have integrated them into their worldview.
Second, therapists are experts in the concept that we all construct models
of the world that are somewhat arbitrary and that can lead to good or bad
outcomes. More specifically, a great deal of therapy looks like: “I understand
that you see the situation as if it’s ‘X,’ perhaps your life would work better if
you see it as ‘Y’.” Third, while it may be true that all of the various schools
12 Introduction

of therapy achieve equal therapeutic outcomes, it is also clear that they frame
the nature of the world, psychopathology, and therapeutic work quite dif-
ferently. This book attempts to demonstrate that these differences between
the therapeutic schools can be seen as thoughtful attempts to highlight and
delineate some of the major geographic markers of constructed reality. If one
understands the essential assumptions of each major school, there can be a
readiness to understand differing viewpoints on constructed reality.
Finally, while therapy as it is currently practiced is only a bit over a century
old, philosophers, priests, shamen, and all types of healers have been help-
ing people understand how to heal trauma, evolve and mature as individuals,
and ultimately live the good life for thousands of years. When Jerome Frank
developed his theory, he intentionally made it broad enough to include how
people change and how they are healed over all times and cultures. Aldous
Huxley coined the term “perennial philosophy” to describe philosophical and
psychological themes that arise repeatedly across human experience. The
dilemma that psychology currently faces is not a new dilemma for the peren-
nial philosophy. When psychologist Sheldon Kopp wrote a book entitled
If You Meet the Buddha on the Road, Kill Him, he was referring to the prin-
ciple that taking abstractions too literally can minimize both human progress
and the attempt to discern truth. In sum, philosophers of various stripes have
been critiquing literalism—believing we are in fundamental reality when we
are actually in constructed reality—for generations. Integrating some of these
older answers into our current research and outcome dilemma can be helpful
in pointing the way.
That said, at the end of the day this is a clinical book with concrete sugges-
tions aimed at actually enhancing therapeutic outcomes. It may appear that
we have to detour down a few philosophical byways to understand “water”
and the nature of our implicit assumptions. But I attempt to minimize the
detours, to use common sense language, and to ground examples in clinical
cases from my own practice and others.
Take a moment to stop and speculate. Assume that we are operating in
constructed reality, a fluid and amorphous environment where the rules and
values of the culture are made up, an environment which is held in place by
social consensus, and an environment that can be meaningfully altered by
key, charismatic individuals. Given this profound change in perspective, how
might you train new psychologists? And how would you help existing psy-
chologists move from average performance to superior performance?
The purpose of this book is to speculate on what is possible when we
accept that psychotherapy operates in constructed reality. And, since the
concepts of constructionism are already intertwined in every aspect of our
lives and in every therapeutic encounter, it is relatively easy to use clinical
examples and outcomes to support and extend the speculation. Thomas Kuhn
 Introduction 13

tells us: “Though the world does not change with a change of paradigm, the
scientist afterward works in a different world. . . . I am convinced that we
must learn to make sense of statements that at least resemble these” (1962, p.
120). In this sense, the purpose of this book is to invite the reader to enter a
different world—a world of new possibilities, a world that opens the doors to
enhanced therapeutic outcomes.
This book divides itself into two separate but interconnected halves. The
first half of this book, The New Therapeutic Milieu, advances the argument
that psychology is operating in constructed reality not in fundamental real-
ity. This first half also provides a description of the nature of Reality B.
The second half of the book, Enhancing Therapist Effectiveness, focuses on
developing a Reality B model of training that allows therapists to profit from
study and experience. In addition, the second half of the book includes many
vignettes and case examples all of which are presented and analyzed from a
constructionist perspective. While the theoretical presentations contained in
the first half of the book are necessary to analyze the research and present
the theory behind Reality B, most of us learn better from stories and narra-
tives. In this sense, the second half not only focuses on presenting a model
for enhancing therapist outcomes, it also allows the paradigm shift presented
in the first half to assume a human form. It’s appropriate to say that the first
half is about the nature of “water” and the second half explores the ways that
understanding water can enhance clinical outcomes.
And, since we are about to explore the nature of water—and the secret
knowledge—let us close with a relevant quote from the movie The Matrix.

Have you ever had a dream, Neo, that you were so sure was real? What if you
were unable to wake from that dream, Neo? How would you know the difference
between the dream world and the real world?
—Morpheus (Silver, Wachowski, & Wachowski, 1999)
 Part I

THE NEW THERAPEUTIC MILIEU

Mundus vult decipi; ego decipiatur (The world wishes to be deceived;

therefore let it be deceived)
—Petronus, The Book of Quotations (1907)

15
 Chapter 1

Psychology’s Inconvenient Truths

“You will not apply my precept,” he said, shaking his head. “How
often have I said to you that when you have eliminated the impossible,
whatever remains, however improbable, must be the truth?”
—Sir Arthur Conan Doyle, The Sign of the Four,
Sherlock Holmes (1890)

Psychological research is famous for studies that confirm common sense

and generate expected results: trauma in early life leads to higher risk for
pathology in later life, abusing your spouse verbally or physically puts your
marriage at risk, the children of the elite have better options and outcomes
than the children of the poor, and so on. But there are a series of research
results from the therapy outcome literature that are completely unexpected;
when they are taken seriously, these results have radical and disturbing
implications.
The study that embodies these results most succinctly occurred almost
forty years ago. In 1979 Han Strupp and Suzanne Hadley published a study
showing that “understanding” college professors were able to achieve the
same level of therapeutic effectiveness as “highly experienced,” licensed
therapists when doing therapy with neurotics. This study created quite the
intellectual storm. Its direct implication was that psychological training and
experience were insignificant. The possible inferences went even further.
Since experienced therapists have access to specialized professional knowl-
edge—for example, they understand the nature and characteristics of anxiety
and depression better than the lay person—it implies that this special knowl-
edge fails to contribute to outcomes. Since the experienced therapists know
psychotherapeutic techniques—and the professors do not—it implies that
psychotherapeutic techniques fail to contribute to outcomes. And, since the
17
18 Chapter 1

experienced therapists understand psychological theories like psychodynamic

psychotherapy and cognitive behavioral therapy (CBT), it implies that all
that has been studied, researched, and written about those areas also fail to
contribute to therapy. Put another way, it argues that a person who has read a
book on life coaching can hang out a shingle and get the same outcome as a
licensed therapist with twenty years of experience in the room. It argues that
a recovering alcoholic who has gone to some Alcoholics Anonymous (AA)
meetings can match the outcomes of the psychologist with years of experi-
ence treating substance abuse.
These ideas are appalling for psychotherapy; essentially they remove most
of the rationale for calling it a profession. Given the gravity of the impli-
cations, one would think that the Strupp results would generate numerous
studies attempting to refute its conclusions; after all, if the conclusions are
allowed to stand, they would fundamentally disrupt virtually all of psycholo-
gy’s1 claims. Interestingly, while there has been some research looking at the
Strupp claims, in comparison to the search for new techniques, for example,
the examination of the effects of training and experience has been somewhat
limited and circumscribed. However, there are sufficient studies to draw con-
clusions about whether the Strupp results are accurate. And, unfortunately for
psychology, the answer is “yes, the results have been sustained.”
Some of the most important studies in the experience area are meta-analyses;
meta-analyses combine the results from many studies using statistical models
in an attempt to achieve more accurate conclusions. Leon, Martinovich, Lutz,
and Lyons (2005) summarize these meta-analysis results as follows.

As part of the classic meta-analysis by Smith and Glass (1977) demonstrating

the overall effectiveness of psychotherapy, these researchers examined whether
years of experience as a therapist correlated with outcome. The authors found
that years of experience correlated -.01 with effect size (Smith and Glass,
1977). In their 1980 meta-analysis of 485 studies, the correlation was again zero
(Smith, Glass & Miller, 1980). Shapiro and Shapiro (1982) conducted another
meta-analysis in response to the criticisms made of the meta-analysis of Smith
et al. Sample therapists had an average of three years of experience. Despite
improvement in their meta-analysis, these researchers again failed to find a cor-
relation between years of experience and effect size. (p. 417)

These and other meta-analyses were referred to in the following quote from
the “Bible” of the therapy outcome literature, Bergin and Garfield’s Hand-
book of Psychotherapy and Behavioral Change.

[O]verall, the meta-analytic reviews of psychotherapy that have provided cor-

relational data find little evidence for a relationship between experience and
outcome. (Lambert & Ogles, 2004, p. 169)
 Psychology’s Inconvenient Truths 19

Statisticians and behavioral science researchers are always quick to point

out that correlation does not equal causation. Sometimes when there is a posi-
tive correlation between two factors the causal connection is actually due to a
third factor. However, the converse finding—the absence of a connection or
correlation—is often more convincing. In this case, the various meta-analyses
examined a large number of client outcomes and analyzed those outcomes
against therapist experience. The larger the sample size, the more sensitive
the research in terms of finding even small effects. In this sense, the complete
absence of an experience effect is meaningful and convincing and, of course,
troubling.
The next edition (2013) of Bergin and Garfield’s Handbook of Psycho-
therapy and Behavioral Change took another look at the question of experi-
ence. Hill and Knox, in their review of the experience and training literature,
noted that while there have been a number of studies of therapist experience
that showed small positive experience effects, there have been other studies
showing no effect and even a few studies showing the superiority of begin-
ners. These contradictory findings are fairly normal in the outcome literature
and are usually interpreted as evidence that there are weak or no effects.
In support of that, Hill and Knox cite the two recent, larger studies which
directly address the question.

Two recent analyses of very large numbers of therapists perhaps provide the
most definitive evidence about therapist experience. Wampold and Brown
(2005) found no effects for therapist experience level (years of practice) when
they analyzed the outcomes of 6,146 clients seen by 581 therapists in a man-
aged care setting (all therapists were postdegree). Similarly, Okiishi et al. (2006)
found no effects of therapist experience level (pre-internship, internship, post-
internship) on the speed of client improvement in their study of more than 5,000
clients seen by 71 therapists at a university counseling center. (Hill & Knox,
2013, p. 797)

At this point the available evidence suggests that the “no experience” find-
ing of the Strupp study has been sustained.
The training effect literature is weaker than the experience literature but
has many of the same characteristics. In the same summary article, Hill and
Knox cite studies showing small positive effects of training and other studies
showing no effects. They go into some detail describing a study by Anderson
et al., essentially replicating Strupp, which found that graduate students from
other disciplines got the same results as clinical psychology graduate students
when doing therapy. This weak and contradictory literature led to the follow-
ing conclusion: “The results of these studies certainly do not provide direct
evidence for the effectiveness of training; in fact, they call into question the
very necessity of this training” (2013, p. 799).
20 Chapter 1

Scott Miller is a psychologist who has played a central role in terms of

looking at the implications of the therapy outcome literature. Here is his sum-
mary of the effects of training.

Findings from a large, long-term multinational study of behavioral health prac-

titioners confirm that therapists desire to—and see themselves—as continually
improving throughout their careers.
When researchers examine the evidence, however, they find little proof of
increasing expertise. As just one example, in a comparative study of licensed
doctoral-level providers, pre-doctoral interns, and practicum students that
appeared in last spring’s Journal of Counseling and Development, Scott Nyman,
Mark Nafziger, and Timothy Smith found “the extensive efforts involved
in educating graduate students to become licensed professionals result in no
observable differences in client outcome.”
The problem isn’t that professionals are failing to acquire new knowledge
or skills: the problem is that what’s learned is unrelated to improved outcomes.
(Miller & Hubble 2011, p. 30)

And here is Miller’s summary of both training and experience effects

across the professional spectrum.

You can’t do better therapy by attending workshops and you can’t improve your
therapy skills while doing therapy. (Thomas, 2014, p. 1)

The literature has essentially sustained the initial findings of the Strupp
study. The subsequent half century of research finds weak or no effects for
therapist experience or therapist training on client outcomes.
Now, that we have briefly reviewed the experience and training literature,
let us look at some of the additional implications of the Strupp study. Experi-
enced therapists know techniques, they have studied the differing philosophies
of the schools of therapy, and they have been trained in specific information
about diagnostic categories and client characteristics. In other words, they
are trained and experienced in the specialized professional knowledge that
defines the field of psychology. Obviously, the inability of this knowledge to
enhance outcomes suggests that this knowledge holds very little or no value
for client improvement. This hypothesis is even more appalling than the first.
It is one thing to argue that training and experience provide no benefit, but
it is another thing to postulate that all the accumulated theories, techniques,
and specialized knowledge should be discarded. This leaves psychology as an
empty container; virtually all the ideas and research are judged as irrelevant
and the field is required to essentially start from scratch.
To examine this upsetting hypothesis, let’s look at the research from a dif-
ferent angle. Historically, for psychology the most pressing question has been
 Psychology’s Inconvenient Truths 21

“does psychotherapy work?” Happily the thousands of studies that have been
done on that question have answered it in the affirmative: psychotherapy is,
in fact, effective. Scott Miller comments:

The average treated client in most studies published over the last 40 years is
better off than 80 percent of those that do not have the benefit of treatment. By
the way, such results are not limited to tightly controlled randomized clinical
trials but apply to practitioners in real-world settings. A soon-to-be published
study examined the outcomes of practicing clinicians (working, for the most
part, in California) and found they either met, or exceeded, the outcomes
reported in randomized clinical trials. The therapists in the study were a diverse
group (professional counselors, psychologists, social workers, marriage and
family therapists, and psychiatrists) working in diverse ways (using a variety
of approaches) with a diverse population. Unlike most randomized clinical
trials, the clients weren’t limited to a single diagnosis. Co-morbidity was the
rule, not the exception. The bottom line is that most therapists do good work.
(Walt, 2007)

The next most pressing question has to do with the superiority of one
approach over another. Is psychodynamic therapy superior to CBT, for
example? In general, one would expect one school of therapy to be better
than another. After all, they are based on vastly different assumptions and
the techniques differ significantly as well. In spite of this logic, however, the
research results reveal the unexpected. Returning to Bergin and Garfield’s
Handbook, Lambert and Ogle (2004) summarize:

Although there are a large number of therapies, each containing its own ratio-
nale and specific techniques, there is little evidence to suggest the superiority of
one school over another. (Lambert & Ogles, 2004, p. 171)

This finding of no significant differences between schools and treatments

has been found again and again. It is humorously referred to as the dodo bird
effect.

The conclusion of most, but not all, of these reviews is similar to that drawn
by Luborsky, Singer, and Luborsky (1975) who suggested a verdict similar to
that of the Dodo bird in Alice in Wonderland: “Everyone has won and all must
have prizes.” . . . However, meta-analytic methods have now been extensively
applied to large groups of comparative studies, and these reviews generally
offer similar conclusions, that is, little or no difference between therapies.
(Lambert & Ogles, 2004, p. 161)

This is not limited to general outcome studies but also includes techniques
that are especially designed for specific populations. Scott Miller summarizes:
22 Chapter 1

Also, and more importantly, when the appropriate analyses of the research are
done between so-called “evidence-based practices” and any other approach
that’s intended to be therapeutic—now listen to that—any approach that’s
intended to be therapeutic, you don’t find any difference in outcome between
those approaches. I know this can be hard to believe given the current zeitgeist.
Unfortunately, at the state and federal oversight level, and for an increasing
number of clinicians, it has somehow become “known” that certain treatments
work best for clients with certain diagnoses. For people diagnosed with so-
called “Borderline Personality Disorder,” Dialectical Behavior Therapy is the
“best practice” when, in fact, available evidence indicates that it works as well
as everything else. . . .
Now, I’m not saying that DBT is not effective or that therapists shouldn’t
learn about it, or other approaches. Rather, the point here is something that most
therapists know intuitively: all approaches work with some people some of the
time. The challenge for the practicing clinician is, therefore, not figuring out
what approach works for which diagnosis, but what will work for this person
sitting with me on this day at this stage in their life. (Walt, 2007, pp. 81–87)

These conclusions are vigorously debated by practitioners who are eager to

find specific treatments for specific disorders, so-called evidence-based treat-
ment. While these practitioners can point to some studies that demonstrate
that one technique is better than another for very specific situations, once
these techniques are compiled into a manual and formed into an empirically
derived system, that complex system performs equivalently to other complex
systems such as cognitive or psychodynamic. Hubble, Duncan, Miller, and
Wampold, in their review of manualized treatment programs, state:

Notwithstanding, after more than 40 years of research, evidence that specific

ingredients are needed for resolving particular disorders remains conspicuously
missing. The conclusion is inescapable: “Psychotherapy does not work in the
same way as medicine.” . . . Bluntly put, the existence of specific psychological
treatments for specific disorders is a myth. (Duncan, Miller, Wampold, & Hubble,
2010, Kindle Locations 1023–1027)

Finally, some optimistic psychologists argue that we are always on the

brink of finding a new technique that will embody all of the principles of
human change and lead to a breakthrough in personal growth and healing. As
an example, take Eye Movement Desensitization and Reprocessing (EMDR);
especially when EMDR was first developed there were multiple stories of
seemingly wonderful outcomes. Over time that has faded and the research
shows that EMDR is no more effective than many other approaches for
trauma. Perhaps, however, the next approach will be able to sustain the sizeable
positive outcomes. Maybe mindfulness, when it is fully understood, will be the
breakthrough technique. After all, it has been in use for thousands of years.
 Psychology’s Inconvenient Truths 23

It is always possible that a wonderfully effective new technique might be

discovered. Research results can never prove that the next technique won’t
stand up; research results can never determine the future and research results
can never extinguish hope. But after seventy-five years of sustained work, it
appears likely that the next creative technique, no matter how wondrous, will
also prove unable to differentiate itself from the extant techniques. Wampold
comments:

Clinical trials comparing two treatments should be discontinued. Much money

has been spent on clinical trials, with the same result: “Both treatments were
more effective than no treatment, but there were no differences in outcomes
between the two treatments.” Continued research that looks at new variations
of old treatments will yield little that can be transported to systems of care to
improve the outcomes of clients. (Wampold 2010, Kindle Locations 2089–2092)

In conclusion, this question of “which approach is better” has been

addressed in hundreds and hundreds of studies. Psychologists have been
much more interested in this question than the questions about training and
experience effects. Many of the studies have been conducted by practitioners
who hope that their new ideas and techniques will make a contribution and
move the field forward. Others simply hope to confirm that psychotherapy is
a science; after all, if anything one does gets equal positive results, that result
implicitly suggests psychology is not “science-based.” In sum, the practitio-
ners conducting these studies have been highly motivated and unceasing in
their creative proposals for new and better ways to help clients change. And
with all that effort, we are still stuck with the outcome that pretty much any
credible effort to help a client change gets the same result.
Let’s return to the “dodo bird” effect. While psychology has been in almost
complete denial about addressing the lack of training and experience effects,
there has been quite a lot of discussion about this “all treatments are essen-
tially equivalent” concept. The primary response to these findings has been
the development of common factors theory. Essentially this theory postulates
the existence of “nonspecific” or “common” factors in therapy that are shared
by all schools of therapy—factors which are essentially responsible for thera-
peutic change. The therapeutic alliance is the most oft cited common factor
which Lambert and Ogles (2004) describe as “a therapeutic relationship that
is characterized by trust, warmth, understanding, acceptance, kindness, and
human wisdom” (p. 181). Put in simplest terms, the typical psychologist—
when confronted with the dodo bird conclusion—might say, “Well, I always
knew it was all about the relationship.”
While many psychologists are quick to accept this argument, they fail to
follow it to its logical conclusion. Common factors theory argues that clients
24 Chapter 1

get better because of the power of the therapeutic alliance (nonspecific fac-
tors) plus the power of “specific factors.” Specific factors are essentially all
the factors—techniques, knowledge of diagnostic categories, specialized
training, etc.—that collectively compose psychology’s privileged knowledge
and the specific contributions of each school of therapy. In sum, therapists
might say that it’s “all” about the relationship but very few of them actually
believe that all the specific factors are completely ineffective. If they believed
that, they would need to stop reading books, attending workshops, and giving
and receiving supervision.
If it’s “all about the relationship,” one quickly arrives at the placebo theory
of psychotherapy. This theory argues that if a client is motivated to get better
and approaches any helper who seems to be legitimate, the ensuing psycho-
therapeutic work will result in a significant and reliable therapeutic improve-
ment. The expectation of success and the credible context create the positive
change. There is no “specialness,” no magic in therapy; the belief one is
going to get better—given a credible encounter—makes one better. Therapy
is a kind of “sugar pill.” Lambert and Ogles (2004) comment:

[O]ne might conclude that the benefits of therapy are not caused by the specific
treatments, but rather by a generalized placebo effect (i.e., that psychotherapists
are merely “placebologists”). (p. 150)

This may be a logical conclusion but it is a hundred miles away from what
psychologists actually mean when they say, “It’s all about the relationship.”
Virtually no one is ready to throw away most of the work of the past century
and assert that everything actually done in the room is a credible placebo
whose specific form is insignificant.
At the risk of generating some math anxiety, common factors theory
is easily expressed with basic algebra. Where CF = common factors and
SF = techniques, theoretical orientation, and knowledge that is specific to a
particular school.

CF( the relationship ) + SF( unique to the school ) = Total Effect Size

Since the Total Effect size of every school is equal, we get the next formula.

CF( the relationship ) + SF( unique to one school ) = CF( the relationship ) + SF( unique to another school )

Subtracting the common factors, we get.

SF( unique to one school ) = SF( unique to another school )

 Psychology’s Inconvenient Truths 25

This simple bit of algebra shows that the dodo bird effect implies that the
effect size due to specific factors of any school of therapy is exactly equal to
the effect size due to specific factors of any other school.
There are two possibilities here: either the specific factors are important
and significant (greater than zero) or the specific factors equal zero. The idea
that the specific factors are important immediately runs into a logical issue.
More specifically, how can the schools of therapy achieve equal results when
their assumptions and techniques differ so significantly? For example, psy-
chodynamic psychotherapy emphasizes the power of the unconscious mind
while cognitive behavioral approaches formally deny it. One would think that
one of those schools is correct—or at least closer to reality—and that their
results would, therefore, be superior. But even on this most basic assumption
about the importance/irrelevance of the unconscious, the research results say,
“no significant differences.” Similarly, the humanistic/existential schools are
based on assumptions about the inherent health and completeness of each
human being. Contrast that with the psychodynamic school which priori-
tizes the core importance of human trauma and psychopathology. Shouldn’t
this large difference in assumptions result in outcome differences? Finally,
systems theories see individuals as embedded in and strongly affected by
families and larger systems. If in fact humans are social animals whose every
choice is affected by social context, shouldn’t that approach get better out-
comes than schools that look solely at the individual? Finally, recall that the
dodo bird effect is not limited to the four major schools of psychotherapy;
the Wampold recommendation for no more comparative outcome studies
includes the observation that thirty or forty “minor” psychotherapy schools
also get exactly the same positive effect. In sum, given these substantial
differences in philosophy, techniques, and specific knowledge, it is highly
unlikely that the effect sizes would be exactly equal to each other.
When you add the finding that training and experience do not contribute to
increased effectiveness the conclusions become clear. If the systems actually
contributed to the effect size, via different but equivalent principles, then peo-
ple who studied the systems would be more effective than change agents who
have not studied the systems. Trained therapists should best the untrained
if the systems have anything concrete to offer. However, the research does
not demonstrate that superiority. And, recall the literature summary from
Wampold above, “Bluntly put, the existence of specific psychological treat-
ments for specific disorders is a myth.”
The dodo bird effect goes past Strupp and implies that the power of tech-
niques is not responsible for change. This in turn suggests that understand-
ing the worldview of each system—for example, the nature of the psyche
according to systems theory—also fails to contribute. And, finally, even
26 Chapter 1

specific knowledge about clients—how alcoholics differ from “normies,” for

example—also fails to contribute.
Before attempting to integrate these conclusions, it is useful to perform one
more analysis, this one from the perspective of differing professions. Each
profession or trade is defined by its own privileged knowledge; generally this
knowledge consists of techniques and specialized information that is unavail-
able to a lay member of the culture. Typically, this privileged knowledge is
so important that one cannot function in the profession without it. And it is
large enough that the practitioner cannot master it completely during train-
ing; it requires years of practice and continued effort to become an expert
practitioner. Take the simple example of a car mechanic. A lay person will be
unable to rebuild an engine without training. And there are so many cars with
so many features—that is, the extent of specialized knowledge is large—that
the master mechanic will always best the beginning mechanic. If we were
conducting research on the effects of training as a mechanic, it would be easy
to demonstrate an enormous effect size from training and an equally large
effect size from experience.
Most professions and trades have these qualities. A lay person can’t cal-
culate the thrust necessary to put a satellite into orbit; one must be a trained
physicist or engineer. A lay person can’t design a new CPU or evaluate the
strengths and weaknesses of the existing CPUs on the market. A researcher
in these fields might ask a question like “which training model works best for
learning to be a mechanic?” but they would never waste time asking if train-
ing is better than no training. The answer is so obvious that it is unnecessary
to even ask the question.
Now imagine that we are taking a look at training effects in high school
math teachers. For this exercise, imagine that they are all competent math-
ematicians; that is, they have already mastered math at a high school level
and we are only looking at their teaching abilities. How is learning to teach
different than learning to be a cardiac surgeon?
First, in teaching—as opposed to the professions we have reviewed thus
far—a lay person will do just fine. If one knows high school math, training is
not required to teach students the subject. Moreover, beginners will probably
equal experienced teachers and in some cases their performance might sur-
pass that of the experienced. We are all familiar with the brand new teacher
who is so fired up and so connected to the students that they do an excel-
lent job right off the bat. We all know teachers who have retired from their
previous job and teach for the love of teaching who also do an exceptional
job without any specialized training in how to be an educator. And we all
know experienced teachers whose years in the field fail to guarantee superior
performance. In sum, education seems to belong in a completely different
category than the first fields we reviewed.
 Psychology’s Inconvenient Truths 27

And there are a number of other fields similar to teaching. For example,
leadership, organizational management, and sales are all fields where training
is neither necessary nor documented as effective. Moreover, in those fields,
experience fails to guarantee superior performance.
If we were to speculate on the differences between the two types of profes-
sions—the ones with training effects and the ones without—we might come
up with theories like: the first group of professions are concerned with mas-
tering the material world and the second group is concerned with complex
human interactions. One could also argue that the first type of field fits the
scientific model and the second type is incompatible with it. In this book, we
are going to use the terminology of professions that operate in fundamental
reality versus professions that focus on socially constructed reality. The next
two chapters will be devoted to defining and understanding the difference
between those two terms.
What are the implications for psychotherapy of this analysis of profes-
sions? First psychology has been endeavoring to become a field of the first
type. All the research, all the diagnostic categories, all the theoretical mod-
els, and all the development of techniques are an attempt to manufacture
privileged knowledge that will serve to differentiate the psychological profes-
sional from the lay person. Second, the research results prove that psychology
has failed to accumulate meaningful privileged knowledge in spite of all this
effort. Third, psychology presents itself to the public as a profession with
privileged knowledge and the public talks about psychology in that man-
ner. For example, the public believes that training and experience enhance
outcomes and that there are specific treatments for specific disorders. Fourth,
even when psychologists know the research, the dodo bird effect, and psy-
chology’s similarity to teaching and leadership, its practitioners also believe
that it is a first type profession that can be explored and enhanced through the
scientific method.
Accepting these facts requires the reader to move from a Reality A per-
spective to Reality B. In Reality A, the assumptions of psychology—that it
is a scientific profession with significant privileged knowledge—hold true.
In Reality B psychology is revealed as a type 2 profession that will require a
different kind of paradigm. Two factors give rise to optimism. First, psycho-
therapy works. Second, the research clearly shows that some therapists get
significantly better results than others. Taken together these two factors imply
that we can take a model that is already working, make it better, and then train
therapists to enhance their results.
However, these possible outcomes rest on an important first step: we must
accept that we are in Reality B. As long as the vast majority of psychology’s
resources are focused on a futile attempt to prove that we are a type 1 profes-
sion—that we operate in the material world and that our primary tool is the
28 Chapter 1

scientific method—we will continue to repeat the lack of progress that char-
acterizes psychology at this point. Scott Miller describes our current level of
evolution:

During the last few decades, more than 10,000 “how to” books on psycho-
therapy have been published. At the same time, the number of treatment
approaches has mushroomed, going from around 60 in the early days to more
than 400. There are presently 145 officially approved, manualized, evidence-
based treatments for 51 of the 397 possible DSM diagnostic groups. Based on
these numbers alone, one would be hard-pressed not to believe that real progress
has been made by the field. More than ever before, we know what works for
whom. Or do we?
Comparing today’s success rates with those of 10, 20, or 30 years ago is a
way of finding out. One would expect that the profession is progressing in a
manner comparable to the Olympics. Its fans know that during the last century,
the best performance for every event has improved—in some cases, by as much
as 50%. What’s more, excellence at the top has had a trickle-down effect,
improving performance at every level. The fastest time clocked for the marathon
in the 1896 Olympics was just 1 min. faster than the time currently required just
to participate in the most competitive marathons like Boston and Chicago. By
contrast, no measurable improvement in the effectiveness of psychotherapy has
occurred in the last 30 years.
The time is come to confront the unpleasant truth: our tried and true strategies
for improving what we do have failed. Instead of advancing as a field, we’ve
stagnated, mistaking our feverish pedaling on a stationary bicycle for progress
in the Tour de Therapy. (Miller, Hubble, & Duncan, 2007, p. 31)

We’re going to need to accept the research results and the analysis of pro-
fessions, work to understand the fact that psychology operates in Reality B,
and use those insights to enhance our results.
Let’s take a closer look at the widespread denial inside psychology
about these results. Consider for a moment just how profound the denial of
psychology has been. The research results are not secret; the Strupp study
was widely discussed back in 1979, the Bergin and Garfield quotes are
from the most well-known summary of outcome research, and Miller and
his colleges have been disseminating his primary conclusions via books,
articles, workshops, and keynote speeches. It takes only a moment of reflec-
tion to perform the analysis of professions and recognize that psychology
essentially has no privileged knowledge. Given how easy it is to put these
arguments together, the inability to do so suggests that there are powerful
forces in the collective and individual psyche that resist such conclusions.
Identifying and understanding those forces are an important first step
toward mastering Reality B.
 Psychology’s Inconvenient Truths 29

BUILDING AND SUSTAINING WORLDVIEWS

Man can seldom—very, very, seldom—fight a winning fight against

his training; the odds are too heavy.
—Mark Twain, Europe and Elsewhere (1923)

It is common knowledge that humans are expert at ignoring information that

would contradict a comfortable worldview. In fact, the comic and political
commentator, Bill Maher, finds this human tendency so amusing that he
makes it a central part of his comedic approach. Maher calls this tendency
to filter out disconfirming information “living in the Bubble.” To Maher, the
Bubble is a cognitive filter which allows “Republicans” to maintain stable
political beliefs and to discount any facts which might threaten those beliefs.

Winston Churchill once said in wartime, “the truth is protected by a bodyguard

of lies.” In America today, Republican voters are protected by a bodyguard of
“duh”—a thick shell of super hardened bullshit, a membrane so tough that the
only thing that gets in is FOX news and the only things that come out are mis-
spelled signs and babies.
Has this ever happened to you: you go home for Thanksgiving and your uncle
from Ohio is there, who you thought was normal, but soon the discussion turns
to politics and he says, “that Barack Obama wants to use the UN to seize our
guns and give them to his Negro army of ACORN volunteers.” And you think,
“What! Where is he even getting this stuff?”
Trying to get today’s Republican to accept basic facts is like trying to get
your dog to take a pill. You have to feed them the truth wrapped in a piece
of baloney, hold their snouts shut and stroke their throats. And even then, just
when you think they’ve swallowed it, they spit it out on the linoleum. Gore
called his project “24 hours of reality” and that’s the problem. Half the country
doesn’t believe in reality. (Maher, 2011)

Obviously a Republican commentator might argue that Democrats have

an equivalent bubble and they would certainly have a point. For the purposes
of this book however it is not Republicans versus Democrats; rather, it is
Maher’s witty yet painfully accurate description of how people resist learn-
ing from experience. Could something equivalent be operating in the therapy
room and be responsible for therapists’ inability to learn from thousands of
hours of direct contact with patients?
Fortunately, Nobel Prize winning psychologist Daniel Kahneman has writ-
ten a book which precisely addresses this question. The title of his book is
Thinking, Fast and Slow but it easily could have been entitled How People
Build Comprehensive Realities from Limited Data; then Rationalize Them,
30 Chapter 1

and Finally Deny All Contradictory Information. In his book, Kahneman

gives a number of examples of how the “Bubble” functions.
His first example consists of a consultation with a Wall Street wealth man-
agement firm. This firm was both prestigious and successful and literally had
hundreds of millions of dollars under management. End of year bonuses for
the specific money managers were awarded based on each manager’s perfor-
mance for the year. Prior to his formal consultation meeting with the firm’s
executives, Kahneman was given the performance data for the top twenty-
five money managers over the past eight years.
Unfortunately for the managers, Kahneman’s statistical analyses revealed
a zero correlation between performance from one year to the next. In other
words, his statistics proved that the advisors had no skill at all at stock pick-
ing and money management and their results were solely due to chance. The
quote below, where Kahneman reports these results to the firm’s top execu-
tives, is a perfect example of a “Bubble,” of people filtering information in a
way that leaves their current view of reality intact and unaffected by the new
information. Kahneman began by asking the executives to estimate the cor-
relation between performance and the managers.

They thought they knew what was coming and smiled as they said “not very
high” or “performance certainly fluctuates.” It quickly became clear, however,
that no one expected the average correlation to be zero.
Our message to the executives was that, at least when it came to building
portfolios, the firm was rewarding luck as if it were skill. This should have been
shocking news to them, but it was not. There was no sign that they disbelieved
us. How could they? After all, we had analyzed their own results, and they were
sophisticated enough to see the implications, which we politely refrained from
spelling out. We all went on calmly with our dinner, and I have no doubt that
both our findings and their implications were quickly swept under the rug and
that life in the firm went on just as before. The illusion of skill is not only an
individual aberration; it is deeply ingrained in the culture of the industry. Facts
that challenge such basic assumptions—and thereby threaten people’s liveli-
hood and self-esteem—are simply not absorbed. The mind does not digest them.
(Kahneman, 2013, p. 216)

This is a perfect description of the “Bubble”—of living life with active fil-
ters which preclude one from learning from experience. Kahneman is arguing
that the filters automatically kick into effect when there is a threat to “liveli-
hood and self-esteem.” Accepting this new information that the firm and its
advisors are a complete fraud and that they add nothing of value to the man-
agement of their clients’ wealth is an unacceptable truth. Before proceeding
and allowing Kahneman to explain the mechanisms of filtering, it is helpful
to look at another example of the “Bubble” in a different context.
 Psychology’s Inconvenient Truths 31

Kahneman reports that he had a job in the Israeli army as a psychol-

ogy officer where he was responsible for evaluating candidates for offi-
cer training. He and others in his group would watch the candidates run
through field exercises designed to show leadership, being a team player,
perseverance, feedback skills, and so on. After observing these exercises,
Kahneman and his colleagues would meet, discuss their results, and make
their recommendations about the suitability of each candidate for officer
training.

Because our impressions of how well each soldier had performed were generally
coherent and clear, our formal predictions were just as definite. A single score
usually came to mind and we rarely experienced doubts or formed conflicting
impressions. (Kahneman, 2013, p. 211)

They received feedback later about how the candidates were doing and
were surprised to find that their rankings were almost completely incorrect;
the officers’ subsequent performances essentially had a negligible correlation
with Kahneman’s predictions. He reports that they were initially depressed
about these results but quickly recovered. The army still required them to
use the obstacle field and rank the new candidates. And again, the quality
of leadership seemed apparent to Kahneman. In spite of the information that
their estimates had low correlations with actual performance, he had the same
confidence that his results could be trusted.
Once again we see the operation of the Bubble: the fact that performance
on the field exercise had little or no power to predict officer effectiveness was
disregarded due to the seductive clarity of the present experience. The key
word here is “seductive.” Kahneman goes to some pains in a different part
of his book to describe the human tendency to confidently generalize from
one small piece of information to large conclusions. It’s as if the mind has a
tendency to build worlds that are coherent and make sense. If we don’t have
enough information to accurately predict or describe a world, we will still act
as if we have enough. Apparently, we have a compulsion to build a complete
worldview regardless of how little we know and ultimately, in spite of how
inaccurate our world turns out to be. And after this world is built—regardless
of how shaky its foundations might be—we have great confidence in it. Not
only are we sure of its implications, but the longer we work with it, the more
it dominates our perspective. Over time we lose the ability to see the data
from any other point of view.
In order to explain these Bubble effects, Kahneman presents a two part
model of the mind which he calls System 1 and System 2. System 1 cor-
responds to “thinking fast” and System 2 corresponds to “thinking slow.”
System 2 is easier to describe and understand. It specializes in effortful,
32 Chapter 1

analytical, mathematical, logical, and rational reasoning—hence, thinking

“slow.” Kahneman states:

System 2 allocates attention to the effortful mental activities that demand it,
including complex computations. The operations of System 2 are often asso-
ciated with the subjective experience of agency, choice, and concentration.
(Kahneman, 2013, p. 21)

Later in this book we will review some key parts of the work of Allan
Schore, noted neuroscientist, who also has a two part model of the mind. In
Schore’s model, Kahneman’s System 2 corresponds to what he calls “left
brain” activity. Schore goes further and suggests that left brain corresponds
to Conscious Mind. As one would expect, in Schore’s terminology, Kahne-
man’s System 1 corresponds to “right brain” and Unconscious Mind.
Kahneman himself studiously avoids those terms from neuroscience and
psychodynamic psychotherapy; he notes, “The use of such language is con-
sidered a sin in the professional circles in which I travel,” (p. 28) and limits
himself to more objective descriptions of System 1 and System 2. The first
thing Kahneman says about System 1 is that it “operates automatically and
quickly, with little or no effort and no sense of voluntary control” (p. 20). Sys-
tem 1 is responsible for quick assessments of danger versus safety, friend ver-
sus enemy, desirable versus undesirable. It stores stereotypes, assumptions,
associations, and snap judgments and effortlessly overlays them on the world.
Kahneman believes that System 1 was evolved to fulfill an evolutionary
purpose of keeping us safe both physically and emotionally. The physical
safety is straightforward: System 1 is biased toward determining threatening
versus unthreatening situations quickly and effortlessly. Kahneman presents
a great deal of research showing that this threat assessment isn’t rational and
reasonable; rather, System 1 is designed to overweight the threat of every
situation and irrationally prioritizes the sure thing and avoidance of pain over
healthy risk taking.
Not only does System 1 keep us safe from physical dangers, it also keeps
us emotionally safe and relatively free from anxiety by developing a world-
view that is cohesive and predictable. Kahneman describes the worldview
creation aspect of System 1 as follows.

The main function of System 1 is to maintain and update a model of your per-
sonal world, which represents what is normal in it. The model is constructed
by associations that link ideas of circumstances, events, actions and outcomes
that co-occur with some regularity, either at the same time or within a relatively
short interval. As these links are formed and strengthen, the pattern of associated
ideas comes to represent the structure of events in your life, and it determines
 Psychology’s Inconvenient Truths 33

your interpretation of the present as well as your expectations of the future.

(Kahneman, 2013, p. 71)

This worldview function is every bit as important as the risk avoiding func-
tion; human beings become paralyzed and terrified when directly exposed
to chaos and unpredictability. The sense that “anything can happen” creates
profound anxiety in most people. The belief that the world is unordered and
unpredictable can even create paralysis and a fugue state. It is something to
be avoided at all costs. Kahneman comments:

The sense-making machinery of System 1 makes us see the world as more tidy,
simple, predictable, and coherent than it really is. The illusion that one has
understood the past feeds the further illusion that one can predict and control the
future. These illusions are comforting. They reduce the anxiety that we would
experience if we allowed ourselves to fully acknowledge the uncertainties of
existence. We all have a need for the reassuring message that actions have
appropriate consequences, and that success will reward wisdom and courage.
(Kahneman, 2013, pp. 204–205)

The beneficial functioning of System 2 is obvious; that kind of effortful

thinking allows humans to plan, to calculate and estimate the future more
rationally and carefully, and to figure out connections and patterns which are
not apparent to the “jump to conclusions-oriented” System 1. Regardless of
these strengths, Kahneman calls System 1 the “hero” of his book. He believes
that in spite of System 1’s weaknesses and flaws, it dominates human judg-
ment and decision-making. Furthermore, while humans pride themselves on
identifying with System 2 functioning, and consider themselves rational and
reasonable, in truth, the vast majority of our judgments and decisions about
the world are determined by System 1. And, while System 2 occasionally
overrules System 1, far more often System 2 simply lets the judgments of
System 1 slide by.
Even more significantly, System 2 functions as a justifier of the System 1
assessments. Kahneman literally believes that “[i]n the context of attitudes,
however, System 2 is more of an apologist for the emotions of System 1 than
a critic of those emotions—an endorser rather than an enforcer” (Kahneman,
2013, p. 103). In sum, the worldview formation process stands rationality
on its head. Instead of starting with a rational and logical weighing of the
alternatives and then forming a conclusion, people make the judgment based
on System 1’s feelings and then use System 2’s logic and left brain rational-
ity to justify the decision. This is sufficiently important to be reemphasized.
Kahneman believes that people form cohesive and irrational worldviews
based on System 1 “gut feelings” and then, afterward, use their rational and
34 Chapter 1

articulate System 2 to justify them. We paper over our irrational assumptions

with rational justifications.
To further illustrate the contrast between System 1 and System 2,
­Kahneman uses the example of an optical illusion. Consider the figure below.
As one might expect, all three dogs are the same height, a fact which can
easily be verified by a ruler. It is one of the functions of System 1 to make

Figure 1.1 Image created by Aidan Barcia-Bacon.

 Psychology’s Inconvenient Truths 35

quick judgments about relative size. And System 1 insists that the dog on the
right is much larger than the dog on the left. Even after System 2 measures
the figures and verifies that they are equal, System 1 continues to see the size
of the figures as different. It is a simple example of how one can know a fact
through the operation of System 2 and continue to “feel” as if a different
“fact” were true via System 1. The System 2 findings do not automatically
supersede the System 1 “truth” even when it clearly describes reality more
accurately. Very few people can “see” the dogs as the same height.
Of course, the drawing is not simply an example, it is also an analogy. Just
as one cannot “see the truth” about the dogs even after applying the ruler,
similarly the financial advisors were unable to absorb the truth about their
lack of skill in spite of the convincing statistics. And Kahneman specifically
noted how the psychology officers, including himself, were unable to aban-
don the sense that their field exercises predicted leadership even after they
had solid feedback proving that their predictions were inaccurate.
Even in the simple example of the optical illusion above, it is almost
impossible to absorb a System 2 finding when it is in contradiction with
System 1. Given that difficulty, what chance is there that an individual can
discount a System 1 certainty when the facts are more ambiguous and com-
plicated than a ruler and an optical illusion. How often does a Democrat
succeed at converting a Republican through a System 2-type discussion?
And, more relevant to our analysis, how easy is it to let go of the feeling that
one’s psychotherapy system of choice—be it psychodynamic, systems, or
humanistic-existential—accurately and completely describes the inner world
of the psyche? The even more compelling question concerns the value of
experience. How easy is it to absorb that experience fails to make me a bet-
ter therapist when experience improves performance in so many other areas
of my life. The feeling that experience improves my performance trumps the
System 2 rationality of the research results.
The research findings may be logical and compelling but, because of the
power of System 1, I cannot absorb them. Although the research facts have
been well known for many years, they have yet to be integrated into either
psychology training models or psychology practice models. And, without
great personal effort, it is likely that this lack of integration will continue.
Let us add one final example from the psychotherapy field. Barry Michels
is the co-author of the best-selling psychotherapy book The Tools. In the first
chapter of his book, Michels describes his view of the psychotherapy bubble
in a way that illustrates the power of System 1 in psychotherapy supervision.
His example brings to mind the old saying “if all you have is a hammer, then
everything is a nail.” Michels has approached his two supervisors about a new
client, Roberta, who wants help dealing with an uncomfortable feeling. Notice
how Michels’ supervisors insist on fitting all data into their preexisting model.
36 Chapter 1

I described Roberta’s demand to them. Their response confirmed my worst

fears. They had no solution. Worse, what seemed to me like a reasonable
request, they saw as part of her problem. They used a lot of clinical terms:
Roberta was “impulsive,” “resistant,” and “craved immediate gratification.”
If I tried to meet her immediate needs, they warned me, she would actually
become more demanding. Unanimously, they advised me to guide her back to
her childhood—there we would find what caused the obsession in the first place.
I told them she already knew why she was obsessed. Their answer was that her
father’s abandonment couldn’t be the real reason. “You have to go even deeper
into her childhood.” I was fed up with this runaround: I’d heard it before—
every time a patient made a direct request, the therapist would turn it back on
the patient and tell him or her to “go deeper.” It was a shell game they used to
hide the truth: when it came to immediate help, these therapists had very little
to give to their patients. Not only was I disappointed, I had the sinking feeling
that my supervisors were speaking for the entire psychotherapeutic profession—
certainly I’d never heard anyone say anything else. I didn’t know where to turn.
(Stutz & Michels, 2012, p. 4)

Note that Michels talks about a “shell game to hide the truth.” This is not
a statement about poor ethics, it is clear that Michels sees his supervisors as
sincere people. Rather it is a statement about an implicit blindness which
becomes apparent when one looks at a System 1 decision from a System
2 standpoint. Michels has come to believe that experienced psychothera-
pists—his respected supervisors—have created a worldview that takes any
input from the client and slots it into preexisting categories. In this example,
the existing categories are psychodynamic and he is urged to go deeper into
the client’s childhood experiences whether this approach works or not. He
also describes how the implicit worldview discounts information about what
works and what doesn’t. And Michels has almost no chance of helping his
supervisors see their limitations; System 1 makes them comfortable with their
choices and perspectives.
The parallels between the different Bubble stories are fairly obvious.
The varying worldviews are established with the primary goal of making
the worldview creator feel safe and making his world predictable and com-
fortable. However, instead of admitting the real purpose, the worldviews
are sold, marketed, and rationalized as being true, accurate, and effective
maps of reality. Maher’s Republicans claim they evaluate political facts
and come to educated and enlightened conclusions; Maher believes they
pretend to be rational but are using their worldview to be stable, safe, and
comfortable. The money managers say they are using their skills to invest
their clients’ wealth and achieve returns that an unskilled investor could not
match; analyses show that their skills are nonexistent and they are using
market variability to hide their ineffectiveness. The Israeli psychology team
 Psychology’s Inconvenient Truths 37

claims to have insight into potential officer effectiveness but ignores the
fact that their field exercises are poor metaphors for leadership. And the
senior psychotherapists are more interested in maintaining their positions
and opinions than in actually meeting the needs of their clients or addressing
the real concerns of their supervisee. Interestingly in all four examples the
actual situations are so ambiguous that it is hard to prove that the worldview
creators are ineffective and fraudulent. Predicting good officer candidates,
having the right political opinion, managing money in an up and down
market, and defining real therapeutic change are all tricky. The worldview
creators can easily justify their positions as rational and accurate. And one
can imagine that it would be almost impossible to win an argument with
the worldview creators about the validity of their positions, especially when
abandoning their positions would hurt their livelihood or status or create a
sense of chaos and anxiety.
As a way to summarize this section, let us imagine that a psychologist who
has expertise in ethics has been asked to write an Informed Consent Form for
all clients who are about to invest their hard-earned savings at the Wall Street
firm which Kahneman mentions. The form might look something like this.

• You acknowledge that I have told you that I have no greater skills in manag-
ing your money than any lay person.
• However, because I can speak the “language” of a stock market expert,
your System 1 will be led to believe that I am superior to you at money
management.
• While this won’t increase your financial returns, it is likely you will have
a decrease in market-related anxiety “believing” that you have put your
money in the hands of an “expert.”

While this form fits the facts as Kahneman presents them, it will feel com-
pletely untrue to the money managers. In spite of the facts, they “know” they
understand the market and they believe they bring real value to their clients.
These beliefs are sustained by the fact that the markets generally go up over
time, allowing the managers to “mistake luck for skill.” The parallels between
an upwardly biased market and the fact that most clients get better regardless
of therapist, approach, and techniques are obvious.
As part of our summary, an equivalent Informed Consent Form can be
written for psychology. Imagine that you are the director of training at a
clinical psychology program. It is the first day for the new class of graduate
students and they are at their first class in Systems and Theories of Psycho-
therapy. Because you take both the research findings and the Code of Ethics
seriously, you have prepared an Informed Consent Form which might go
something like this.
38 Chapter 1

• We will teach you psychotherapy systems which will appear to be good

maps of how to change people but we acknowledge that familiarity with
these maps won’t actually make you a more effective therapist.
• We will teach you about characteristics of different client populations but
that knowledge won’t actually make you a more effective therapist.
• We will provide you with hundreds of hours of client contact and supervi-
sion but those hours won’t make you a more effective therapist.
• And, even though you sign this informed consent and acknowledge the
accuracy of our warnings, because of the effects of System 1, part of you
will continue to believe that our training program has made you a more
effective therapist.

Obviously such an Informed Consent Form will never be produced on the

first day of training for new graduate students. While Kahneman’s argument
that it is hard to absorb new facts when they threaten one’s successes, sense
of self, and livelihood is certainly true, that is not the main reason we will
never see this Informed Consent Form. Rather, it is due to the overwhelming
power of System 1.
In spite of the research findings, no clinical director would advance such
a Form because all of psychology’s systems, theories, training experiences,
and supervision continue to “feel” as if they make an enormous difference
even though the facts refute the feelings. Kahneman calls System 1 the “hero”
of his book. Since it is obviously not the “hero” because of its accuracy, we
must assume that it is the “hero” because of its power—because it allows us
to function in a world permeated by chaos and danger. Few humans could get
out of bed in the morning if they had to face the threats and uncertainties of
their world without the comfort that System 1 provides.
I have great sympathy for our imaginary clinical director. I am one of
those people who cannot see the three dogs in the optical illusion as being the
same size even after I measure them. Similarly, it is very difficult for me to
feel and believe that all of the psychology books that I have read and studied
have failed to help me be a better therapist. Just like Kahneman’s military
psychology team, each time I read the “masters” in psychology—whether
they be Jung, Haley, or whomever—I feel enriched, educated, strengthened,
and enlightened. In spite of all those System 1 feelings, however, I do feel a
responsibility to integrate the powerful and compelling research findings into
my worldview.
At this point, whenever I am presenting this material in a workshop to
professionals, I always stop and take questions. Remember, regardless of how
convincing the research findings are to System 2, System 1 absolutely refutes
them because they do not “feel true.” Then, as Kahneman argues, people use
System 2 arguments to prove their System 1 feelings are the “real truth.”
 Psychology’s Inconvenient Truths 39

Failing that, they will replicate the money managers in the example above
and simply disregard the findings.
The first argument that is usually advanced in a workshop is that the
research is so primitive that the real effects of training, experience, and
psychotherapeutic systems have simply been missed. It is, of course, rather
incongruent to argue that the outcome research proving therapy works should
be accepted but the same research that shows training and experience do not
contribute should be discounted. These critics get into the indefensible posi-
tion of liking research when it supports what they believe and discounting it
when it violates their System 1-related gut feelings. This argument is particu-
larly embarrassing for psychologists who pride themselves on being science
and research-based mental health professionals.
Moreover, everyone agrees the research works perfectly well when it is
measuring psychological factors that are robust. For example, all the research
show strong effects when it comes to documenting that trauma, poverty, and
early substance abuse predict many problems later in life. The research is not
too “primitive” to pick up on the effects of therapy; rather, the unique effects
of specific psychological systems are too small to be documented. In addition,
the research clearly demonstrates that some therapists are much more effec-
tive than others. If the research supports differential therapist effects, how can
it be too primitive? Clearly the research is sophisticated enough to find robust
effects when they actually exist. We need to trust that the absence of find-
ings when it comes to the effectiveness of experience or psychotherapeutic
systems is just as accurate and trustworthy.
The next argument is that trained and experienced therapists add value to
their clients’ lives in terms of an almost immeasurable dimension of richness
or depth or core-level quality and the outcome research only focuses on crude
outcomes. This critique seems to hold some validity: who can really argue
that a Jungian client, who has been watching his dreams and perceiving his
life as a mythological adventure is not, in some manner, living a “richer”
life than the cognitive-behavioral client who has simply become a bit more
“rational.” Unfortunately, when this argument is extended it implies that
any enriching experience is capable of improving people and that enriching
people enhances therapeutic effectiveness. If enrichment is that powerful,
this argument implies that people who love the outdoors are superior to those
who avoid nature; people who have their life enriched by going to church are
better than non-churchgoers; artists—who dialog with the forces of creativ-
ity—are healthier than non-artists; and people who meditate on the past via
making scrapbooks are superior to non-scrap bookers. Clearly, while many
things in life—including Jungian dream analysis—may enrich one’s depth or
worldview when measured from that particular standpoint, these “enriching”
experiences do not contribute directly to enhancing therapeutic effectiveness.
40 Chapter 1

Regardless of the logic of the Reality B argument, many therapists reply

that it just doesn’t feel true especially because they are sure that their clients
have gotten better on multiple occasions. Of course, in this they are correct;
therapy typically has a modest positive effect. But that is not the point being
argued. Clients do get better but their improvement is not due to systems,
training, or experience. Accepting Reality B requires abandoning faith in
techniques not abandoning faith in client improvement. Becoming a superior
therapist rests on attributing the reason for change to the relevant factors and
letting go of the ones that make no contribution.
Next, the workshop attendees simply state that they know that they are
better therapists than they were when they started and they are sure that they
have learned important things that benefit their clients from their hundreds
of hours of experience. This feeling is shared by the money managers who
“know” they are more effective because they have witnessed the machina-
tions of the market in detail and close up for many years. First of all, both
the therapists and the money managers have, indeed, had many experiences
denied to the normal person. In most cases, they are richer as human beings
for having these experiences. In truth, the money managers “know more”
about the market—just like the experienced therapist “knows more” about
people—but that increased knowledge does not translate to enhanced effec-
tiveness. If I studied the history of Rome, I would know more about Roman
history but that increased knowledge is unlikely to make me a more effective
therapist. As argued above, the filtering process causes the increased knowl-
edge to be organized in such a way that it validates unhelpful theories and is
unavailable as outcome-enhancing learning. In sum, the experience of thera-
pists in the room has in some ways enriched the therapist as a person but that
enhancement does not translate into increased effectiveness.
The next objection is to the concept that “techniques don’t work.”
­Psychologists point out that they have read hundreds of studies that show that
techniques are effective and, often, the techniques are shown to be superior
to a standard treatment. For example, new psychological techniques for treat-
ing headache pain not only must demonstrate that they are effective but often
they must also show that they are more effective than a standard treatment
such as progressive muscle relaxation. If these studies are accurate, and tech-
niques not only work but some techniques are much better than others, then
there is evidence for “specific factors” in psychotherapy and it can be argued
that psychotherapy operates in fundamental reality.
Of course we already know that there are no training or experience effects
that the dodo bird finding demonstrates that there are no specific factors,
and that Strupp and other studies show that psychology is a field that oper-
ates without privileged information. Moreover, the Wampold quote about
the futility of further comparative outcome studies argues that the apparent
 Psychology’s Inconvenient Truths 41

superiority of one technique over another disappears when the research

results are examined more carefully.
This careful reexamination is based on three factors; the preeminence of
one technique over another is due to: 1) poor research design, 2) chance/repli-
cation problems, and 3) allegiance effects. The first two are self-explanatory,
allegiance effects deserve more discussion. Allegiance effects occur when the
authors of the study and/or the therapists in the study are more committed to
one treatment over another. Many studies have shown that therapists get bet-
ter results when they believe in the treatment that they are using. In the vast
majority of outcome studies, the therapists either prefer one treatment over
another or know that the authors have a preference. In sum, once poor design,
chance, and allegiance effects are accounted for, the apparent superiority of
one technique over another disappears.
In spite of these arguments, some attendees continue to make a concerted
attack on the dodo bird conclusion; given that there are studies that show the
superiority of one technique over another, the Wampold explanations fail
to convince them. This argument would have more credibility if the lack of
privileged knowledge is not so apparent. Fields with privileged knowledge
always have strong training and experience effects; we have no such effects.
Whether we like it or not, we have failed to establish privileged knowledge
in psychotherapy. Techniques with inherent power are privileged knowledge;
the lack of privileged knowledge means that Wampold is correct and the dodo
bird verdict is sustained.
Finally we should recall that the actual statement is not “techniques
don’t work,” but rather “all techniques work.” The specific statement being
evaluated is “learning and practicing techniques does not result in enhanced
therapist efficacy.” In spite of the hundreds of studies showing one technique
is better than another in a specific situation, the fundamental conclusion—
techniques have no inherent power—remains intact.
Naturally, there is always the hope that the next technique that is discov-
ered may be the one that finally establishes the existence of specific factors.
If this is Reality A, then this hope is well founded. Unfortunately, psychother-
apy operates in Reality B. We are not being asked to give up hope of becom-
ing more effective. We are being asked to stop looking for effectiveness in
the wrong place. In giving up our devotion to developing new techniques, we
open the door to developing other aspects of the field.
The Informed Consent Form should not be taken as a humorous reference
to the foibles of psychologists but rather as a literally accurate document
from the standpoint of the contributions of psychotherapeutic theory and
training to therapist effectiveness. The fact that it is true from the perspec-
tive of therapeutic effectiveness does not make it true from the standpoint of
personal enrichment. Studying what brilliant writers have postulated about
42 Chapter 1

human pathology, development, and health can be a personally enriching

experience but not an effectiveness-enhancing experience. Confusing these
two concepts—enrichment and effectiveness—tends to stifle our hunger to
become more effective. If I come home every day knowing I have helped
people and feeling that I have touched the “core of being human,” I am not
likely to critique my psychotherapeutic system. If it isn’t broken, why fix it?
Moreover, if my peers report similar feelings, why should I doubt myself?
Scott Miller (2011) comments:

Compounding the problem of isolation is the well-documented tendency of

clinicians to overestimate their level of skill and effectiveness. In one study, a
representative sample of psychologists, social workers, psychiatrists, and mar-
riage and family therapists from all 50 states were asked to rank their clinical
skills and effectiveness compared with other mental health professionals with
similar credentials. Respondents, on average, ranked themselves at the 80th
percentile—a statistical impossibility. It gets worse: fewer than 4 percent con-
sidered themselves average, and not a single person in the study rated their
performance below average. (Miller & Hubble, 2011, p. 26)

Regardless of these feelings, however, it is simply true that experience,

mastery of systems, and expertise in techniques do not improve therapist
effectiveness. It is polite to call this an “inconvenient truth.” In fact, integrat-
ing this truth leaves most therapists in a profoundly difficult place. Letting
in that all my training and experience are for naught, that I am not superior
to the “life coach” who hung out his shingle after two weekends of training,
that I have been misled about what works and why it works, that I have par-
ticipated in advancing that misconstrual with my clients: these are disturbing
implications.
This chapter has presented the research results and advanced Kahneman’s
explanation for why these results have been disregarded. For the purpose of
this book, however, the research is simply the jumping off point; the actual
focus is on the implications of the research.
And there is one primary implication: if we are not going to enhance our
results through techniques, specialized information, and schools of psycho-
therapy, we are forced into a focus on the therapist. Science, by definition,
searches for techniques and tools that are replicable—that any qualified prac-
titioner can employ effectively. Abandoning techniques implies abandoning
replicability; psychology needs to search for experiences and approaches that
make the practitioner more powerful and influential regardless of what they
do in the room. Scott Miller comments:

After all, the research showed the treatment did work, regardless of model. This
led us to discover, or rediscover, that the most neglected variable in outcome is
 Psychology’s Inconvenient Truths 43

the therapist. We’ve investigated methods, we’ve investigated clients in their

pathology, but we haven’t turned our attention to the clinicians. And yet, the
amount of variability attributable to the individual provider trumps technical fac-
tors by eight or nine times. We began to measure outcome and found that some
clinicians were better than others—consistently better. (Millham, 2011, p. 34)

It is important to understand why Kahneman’s explanation for the denial

of the profession has featured so prominently in this chapter. Recall the illu-
sion of the differing sizes of the three figures in the drawing above. We are
programmed to see them as different, and most of us will still see them as
different regardless of how many times we take out our ruler and measure
them. The research results have been clear for forty years but the profession
continues to ignore them. This book attempts to take the results seriously and
discuss the implications of doing psychotherapy in constructed reality. Time
and again this discussion will generate the same results as the figure: it will
seem logically true but it will feel completely false. Readers will find that the
subsequent material in this book requires an ability to avoid being seduced by
System 1 simplicities and a concurrent ability to tolerate incongruent feelings.
It is now time to define the differences between Reality A and Really B.
Everyone is familiar with the characteristics of Reality A—fundamental
reality—but Reality B—constructed reality—is more mysterious. As part of
enhancing therapist effectiveness it is necessary to develop a kind of map or
geography of constructed reality. That is the purpose of the next two chapters.

NOTE

1. Psychology will be used in the text as synonymous with clinical psychology and
psychotherapy. Clearly there are other branches of psychology—for example, physi-
ological psychology—which function differently than psychotherapy and which
encompass different bodies of knowledge. The oversimplified use of the word “psy-
chology” is simply for literary purposes.
 Chapter 2

Close Encounters with the Abyss

The bow of God’s wrath is bent, and the arrow made ready on the
string, and justice bends the arrow at your heart, and strains the bow,
and it is nothing but the mere pleasure of God, and that of an angry
God, without any promise or obligation at all, that keeps the arrow
one moment from being made drunk with your blood.
—Jonathan Edwards, Colonial Prose and Poetry (1901)

Everyone feels the insidious presence of the Abyss. Buddha tells us that the
existence of suffering is the first noble truth. All humans are aware that nega-
tive change is much more powerful, much more rapid, and much more long-
lasting than positive change. Asking why negative and traumatic experiences
are so powerful seems like a waste of breath. It is obvious to virtually every
adult human that life is neither safe nor predictable. Every loss reminds us
that we live suspended above the Abyss and our precarious hold can crumble
at any moment. Every experience of trauma, illness, and injustice recalls this
threat and each one of these experiences eviscerates our state of denial and
our hope that life is meaningful, safe, and rewarding.
The Jonathan Edwards epigraph powerfully conveys the sense of danger
and doom that is part of every human life. Reading Edwards—feeling his
threatening passion—impels the reader into a sense of anomia, of falling into
the Abyss. And even the things that protect us—work, friends, family, reli-
gion, etc.—may fail us in the face of the Abyss. Even epiphanies—with all
their healing, connecting power—can be transformed into ephemeral shad-
ows by the experience of loss, death, disappointment, and failure.
All of these sorts of negative events can be called anomic experiences.
Nomos means ordered, constructed, or lawful. Anomic refers to experiences
which are perceived as destroying order, meaning, safety, or stability; it is
45
46 Chapter 2

the state of being lost, confused, unsure of how to orient or which way to go.
Most traumatic experiences result in some form of anomia. The stability and
safety of the world has been ripped asunder and what remains is a threatening,
chaotic exposure to a reality which is at best indifferent to the self and often
hostile. This chapter examines the anomia lurking just outside the sense of
consciousness. It is waiting, barely held at bay by culture, daily routine, and
social support.

THE DENIAL OF DEATH

And so faintly you came tapping, tapping at my chamber door, That I

scarce was sure I heard you—here I opened wide the door;—Darkness
there, and nothing more.
—Edgar Allan Poe, The Complete Poetical
Works of Edgar Allan Poe (1866)

This concept of the “denial of death” is central to the motivation of all human
beings. Without functional denial in place cultures break down and individu-
als lose a sense of meaning and purpose in their daily activities. In The Social
Construction of Reality, Burger and Luckmann (1966) point out:

The hardest thing that a culture has to deal with is the imminence of death.
Cultures are required to invent elaborate schemes including afterlife, etc. that
function to keep people motivated and compliant even though there is proof all
around that they are going to die. (p. 101)

Burger and Luckmann go on to argue that the reality of imminent death con-
tinues to break through regardless of how many elaborate structures are cre-
ated by the culture. For purposes of this book, however, all that is important
is to note that everyone at some level has some anxiety about their own immi-
nent death. Everyone who functions in a motivated way is practicing some
form of denial—usually characterized as “healthy” denial since it results in
cooperative and motivated behavior. But nothing completely removes the
sense of fragility and ephemerality caused by the presence of death.
The absence of healthy denial is considered mental illness. Post-traumatic
stress disorder is a mental health diagnosis which is given when an indi-
vidual’s denial of death has been stripped away from him violently and sud-
denly. In a formal sense, the diagnosis occurs when one experiences death
or a near-death experience to themselves or those nearby. Symptoms include
flashbacks, anxiety, depression, purposelessness, anomie, anhedonia, and
hypervigilance. Not surprisingly, these are the essentially the same symptoms
 Close Encounters with the Abyss 47

anyone would have if they believed that their death is truly imminent. No one
would call these symptoms a “mental health” problem if they were exhibited
by a group of people about to be executed as part of a genocidal rampage.
Instead, the symptoms would be considered normal and understandable. In
fact, it is considered perfectly healthy and normal if one continues to have
these symptoms for a certain period of time—which varies according to the
culture and the scope of the trauma—following a brush with one’s mortality.
PTSD symptoms are only classified as abnormal and as a mental health diag-
nosis when we believe that people have had sufficient time to recover. In this
sense, the entire diagnosis is socially constructed; that is, it only exists when
the social norms say that the victims should have reestablished their sense of
healthy denial of death. We want them to be as in denial as all the rest of us
so they can get back to the business of living.
Perhaps the most important book which addresses these issues is
The Denial of Death by Ernest Becker. In this Pulitzer Prize–winning book,
Becker argues that the primal motivator in all human activities is the fear of
death. According to Becker, this fear is so paralyzing that all human experi-
ence, culture, institutions, and so on are an elaborate construction designed to
deny the reality of our eventual demise. In the following quote, Becker (1997)
lays out the essential thesis of his book.

The prospect of death, Dr. Johnson said, wonderfully concentrates the mind.
The main thesis of this book is that it does much more than that: the idea of
death, the fear of it, haunts the human animal like nothing else; it is a mainspring
of human activity—activity designed largely to avoid the fatality of death, to
overcome it by denying in some way that it is the final destiny for man. (p. xvii)

Sam Keen, who wrote the introduction to the book, summarizes Becker’s
ideas from a slightly different perspective.

The world is terrifying. To say the least, Becker’s account of nature has little
in common with Walt Disney. Mother Nature is a brutal bitch, red in tooth and
claw, who destroys what she creates. We live, he says, in a creation in which
the routine activity for organisms is “tearing others apart with teeth of all
types—biting, grinding flesh, plant stalks, bones between molars, pushing the
pulp greedily down the gullet with delight, incorporating its essence into one’s
own organization, and then excreting with foul stench and gasses the residue.”
The basic motivation for human behavior is our biological need to control our
basic anxiety, to deny the terror of death. Human beings are naturally anxious
because we are ultimately helpless and abandoned in a world where we are
fated to die. “This is the terror: to have emerged from nothing, to have a name,
consciousness of self, deep inner feelings, an excruciating inner yearning for life
and self-expression—and with all this yet to die.” (Keen, 1997, p. xii)
48 Chapter 2

With these two quotes, Becker (1997) begins to give Jonathan Edwards a
run for the money in terms of evoking a sense of the Abyss. And Becker
sees no easy solution. He does recommend psychotherapy and argues that
it can result in a removal of one’s delusions. Unfortunately, the new aware-
ness simply leads to a further encounter with one’s own mortality and one’s
existential despair.

If you get rid of the four-layered neurotic shield, the armor that covers the
characterological lie about life, how can you talk about “enjoying” this Pyrrhic
victory? The person gives up something restricting and illusory, it is true, but
only to come face to face with something even more awful: genuine despair.
Full humanness means full fear and trembling, at least some of the waking day.
When you get a person to emerge into life, away from his dependencies, his
automatic safety in the cloak of someone else’s power, what joy can you prom-
ise him with the burden of his aloneness? When you get a person to look at the
sun as it bakes down on the daily carnage taking place on earth, the ridiculous
accidents, the utter fragility of life, the powerlessness of those he thought most
powerful—what comfort can you give him from a psychotherapeutic point of
view? (pp. 58–59)

Becker believes that the fear of death answers the question about why humans
are so vulnerable to trauma and loss. When the curtains are rent and the Abyss
yawns beneath one’s feet, it is no wonder that people change so rapidly,
radically, and profoundly. And, of course, with few exceptions, the sudden
immersion into the anxiety implicit in one’s own mortality results in depres-
sion, terror, and decompensation.
Why do we not feel this anxiety constantly? Becker believes that we do
feel it—at least as background anxiety—but most humans are denied the full
experience on a daily basis because we build worldviews that shelter us from
the Abyss. He argues that the constructed world is based on the hero myth
and goes to some effort elaborating on its details. In the sense that Becker
postulates an invented world, developed to hide humans from the truth, he has
much in common with the writers of the film The Matrix.

Morpheus: The Matrix is everywhere. It is all around us. Even now, in this very
room. You can see it when you look out your window or when you turn on your
television. You can feel it when you go to work . . . when you go to church . . .
when you pay your taxes. It is the world that has been pulled over your eyes to
blind you from the truth.
Neo: What truth?
Morpheus: That you are a slave, Neo. Like everyone else you were born into
bondage. Into a prison that you cannot taste or see or touch. A prison for your
mind. (Silver, Wachowski, & Wachowski, 1999)
 Close Encounters with the Abyss 49

Becker’s vision of the construction of the human culture is literally different

than the invented reality of the Matrix and its war with the Machine World.
But the two worlds are equivalent in the way they limit clear thinking,
choices, and, ultimately, freedom. Like Morpheus, he recommends “waking
up” and facing the truth about human existence. And as in the Matrix, “wak-
ing up” transforms the lovely world of illusion into the gritty, painful world
of conscious responsibility.
Since Becker wrote his book in 1976, the fragility of the constructed world
has become even more apparent. The ensuing half century has been the era of
postmodernism, a deconstructive philosophy which has as its aim the tearing
down of illusory assumptions. The remainder of this chapter could have the
subtitle “Worse than Becker Thought” in the sense that each section of this
chapter will present another angle on the Abyss.

EATING THE APPLE OF KNOWLEDGE:

SELF-AWARENESS AND THE FRAGILITY OF IDENTITY

When I was a child, I spoke as a child, I understood as a child, I

thought as a child: but when I became a man, I put away childish
things.
—1 Corinthians 13:11

There is a positive stance toward change in most developing young people.

At each stage of growth we can look back at previous assumptions and under-
standings about life and see that they were based on oversimplifications and
fallacies. Obvious and humorous examples include young people outgrowing
Santa Claus or the Easter Bunny. Just as obviously, developing teenagers start
questioning the black and white teachings of their childhood and ask ques-
tions like “I understand that honesty is important, but when is it right to tell
a lie?” or “Is it best to follow my own vision or to serve others?” Children,
teens, and young adults are always outgrowing ideas like “my parents are all
knowing and infallible,” “my town is the best place in the country,” or “I am
deeply in love and am going to marry my girlfriend.” The vast majority of
individuals have the experience of changing certain beliefs as they mature;
hence, the following are common statements: “I’ve outgrown those beliefs,”
“I used to feel that way but experience changed me,” and, the most famous
“you’ll feel differently when you’re older.”
In this sense, virtually all people see their younger selves as conditioned,
programmed, concrete, and limited. They see their current selves as compara-
tively sophisticated, awake, realistic, and mature. Because human beings do
much of their cognitive development post birth, it is inevitable that everyone
50 Chapter 2

has an evolutionary slant toward the development of consciousness and learn-

ing. Everyone is predisposed to seeing even deeply held beliefs as mutable,
malleable, and potentially naïve.
Of course, many people slow down or even halt this process of examin-
ing their beliefs as they get older; however, even this relative stability does
not negate the feeling that they were foolish and confused when younger
in comparison to their current wisdom and knowledge. There is an implicit
sense that what we believe now is ephemeral and that we may soon outgrow
it. In this sense, everyone is a born philosopher seeking to wake up to what
truly is, to find out one’s true nature, and to throw off all external program-
ming. And, of course, one of the effects of conducting any kind of genuine
philosophical inquiry is that a person becomes less certain of what he knows.
Many people recall Plato’s famous critique of Socrates: “this man, on one
hand, believes that he knows something, while not knowing anything. On the
other hand, I—equally ignorant—do not believe that I know anything.” When
one has the experience of repeatedly rejecting a formerly deeply held belief,
it is normal to start questioning whether one’s current firmly held beliefs are
truly solid. And, since these beliefs are tightly intertwined with the concept
of the self, it is appropriate to say that we all are predisposed to doubt the
solidity of our present self.
Therapy is often described as a process of growing more conscious and
self-aware. By and large, in most types of psychotherapy the client reports
that they are discarding old beliefs and behaviors and replacing them with
more functional ones. This is all well and good, but it also implies that the
new beliefs are also transient and temporary and can easily be replaced by
even more evolved beliefs. Again one starts running into a more transi-
tory and fragile sense of self—a self that seems to be solid at this moment
but also one which is ready to evolve into another self after more self-
examination or therapy or experience. From this point of view, the oft-heard
critique of people who participate in therapy seems particularly telling:
“why bother doing therapy when it is just like peeling an onion? After
every new layer is discovered, there’s another layer just like it underneath
and so on forever.”
This criticism argues against the benefits of insight. The critic is pointing
out that one should not “waste time gazing at your navel when you’re never
going to finish the process; instead get to work on something really important
like making money.” But even this clichéd criticism of psychotherapy reveals
a consciousness embedded in the common sense wisdom of the culture, an
implicit awareness that the self is ephemeral and plastic. The criticism could
safely be recast as: “why bother looking for the self when it doesn’t exist as a
solid object and what you do find will only be solid for a brief period of time.”
In sum, the critics of psychotherapy—of self-awareness and consciousness
 Close Encounters with the Abyss 51

development—implicitly adopt a philosophically sophisticated position not

too different than Plato’s or the no-self stance of a Buddhist.
If the fragility of the self is so apparent even in common culture, it becomes
even more obvious when one undertakes an intentional philosophical search.
Virtually all philosophical inquiry questions the common ways of seeing and
recommends looking below the surface, throwing off assumptions, identifying
and removing blind spots, and having the courage to accept the truth. Take the
following simple philosophical tool from an Indian scripture called the Vedas.

Thus has the Shruti (scriptures) spoken of Atman; “That Thou art.” Of the illu-
sory world, born of the five physical elements, the Shruti says: “Neti, neti” (not
this, not this). (Avadhuta Gita)

This passage recommends using Neti, Neti, or “not this, not that,” as a core
philosophic practice. Essentially the practitioner is asked to examine every-
thing in his life to determine whether it is real. If not, it is to be discarded
and the next assumption examined. According to the Vedas, at the end of
a sustained examination, nothing with form will be left and, therefore, Tat
Twam Asi (Thou Art That).
Contrast this with a relatively modern form of philosophy: Existentialism.
Sartre, one of the most well-known existential writers, penned a novel called
Nausea where his protagonist had reached such a state of consciousness and
awareness that even the hearing of a word with its implicit concepts, assump-
tions, and innate programming could generate a sense of nausea. Camus,
another well-known existentialist, wrote a novel called The Stranger where
the protagonist shows indifference to common human taboos such as murder
and imprisonment. The protagonist exemplifies someone who is so awake
and free that they understand that all taboos are conditioned and programmed;
no meaning arises out of the event itself except as a person chooses to endorse
that meaning. If one is allowed a bit of poetic license, one can imagine an
existentialist who has completed her philosophical inquiry. She is poised
at the edge of the universe with undifferentiated chaos all around her and a
sense of nausea pervading her being. As Sartre says, “I exist, that is all, and
I find it nauseating” (Sartre, 2013).
Buddhism offers a well-known analysis relating to the fragility of the self
that is incumbent in one of its most famous techniques: mindfulness medita-
tion. Mindfulness meditation is a simple practice: one sits quietly, watches the
breath, and practices an awareness of whatever thoughts, feelings, sensations,
memories, etc. flow across the field of awareness. The only conscious effort is
to practice awareness; all that comes into consciousness, therefore, arises on
its own. Every thought, feeling, sensation, etc. is generated by non self; none
of them come from “you” because “you” are simply being quiet and aware.
52 Chapter 2

The beginning meditator finds his mind wandering away from the breath
and often forgets he is meditating. He starts thinking the thoughts and feeling
the feelings and his identity shifts from the aware observer to the thinker/
feeler. However, as soon as he recalls he is meditating, the individual focuses
back on his breath and pure awareness.
The obvious implication of mindfulness meditation for self and identity
is that we are not our thoughts, feelings, sensations, and everything else we
identify as self; rather, we are essentially pure consciousness and pure aware-
ness. To the Buddhist, all thoughts, feelings, and so on are other-generated
and compose what they call “non self” or “false self.”
And, in truth, the Buddhists have a point. If all that I control, my conscious
self, is just watching, then everything else must be non self. My beloved iden-
tity is simply a series of seductive thoughts, feelings, and sensations that pose
as my true nature. Of course, the Buddhists believe that this thought experi-
ment is not sufficient to disprove the false self; they urge people to actually
practice mindfulness meditation and discover for themselves whether they are
truly the observed thoughts or something else. But even this simple descrip-
tion of mindfulness shows the fragility of the self-concept when it is exam-
ined with any kind of systematic process.
Both common sense experience and structured philosophic inquiry lead us
to doubt the existence of a permanent and solid Self; instead we find a Self is
characterized by shakiness versus solidity and fragility versus durability and
permanence. Returning to Kahneman’s System 1, one can see that the human
sense of safety, predictability, and stability is more sustained by denial than
by awareness—more supported by a need for security rather than resting
on factual support. Little wonder that we can change so quickly in a nega-
tive direction when our sense of self is so fragile and rests on such a weak
foundation.

CULTURAL RELATIVITY

Infinite are the paths and infinite the opinions.

—Ramakrishna, The Gospel of Sri Ramakrishna (1910)

Relativity is one of the defining aspects of the Abyss. Perhaps the most
obvious example of this relativity arises from an examination of the almost
infinite variability of human culture.

It is an ethnological commonplace that the ways of becoming and being human

are as numerous as man’s cultures. Humanness is socio-culturally variable. . . .
While it is possible to say that man has a nature, it is more significant to say
 Close Encounters with the Abyss 53

that man constructs his own nature, or more simply, that man produces himself.
(Berger & Luckmann, 1966, p. 49)

In the quote above, Berger and Luckmann ask the reader to address the radi-
cal implications of cultural diversity in a serious manner; essentially they are
saying that people who live in different cultures are educated and conditioned
so differently that they literally inhabit different realities. Imagine yourself
as a member of an indigenous Native American culture who lives with the
expectation of communication with a Buffalo or a Coyote spirit and who
believes that every action in life is being reviewed by those spirits. Every
day this individual hears stories of people he knows having such communi-
cations. The shaman of the tribe is capable of curing illness because he has
the ability to visit the “land of the dead” and return safely. And the people of
the tribe have numerous documented experiences where the shaman’s power
has cured illness in much the same way that a modern Westerner experiences
antibiotics.
What Westerner really understands the reality of a Japanese Samurai in the
sixteenth century in terms of suicide? In that culture, it was not only permit-
ted but required in certain situations. And how can a post-feminist American
woman understand the spiritual duties and obligations of an East Indian
woman in the nineteenth century?
These differences are not simply values or sex roles or spiritual beliefs,
rather they encompass something far more profound and foundational. Alan
Watts comments:

We seldom realize, for example that our most private thoughts and emotions are
not actually our own. For we think in terms of languages and images which we did
not invent, but which were given to us by our society. (Watts, 1966, pp. 53–54)

Where does the unique “I” stop and the culturally created “I” begin? How
much of all that “I ‘freely choose’” has actually been “chosen by ‘me’” and
how many of those choices are programmed? Clearly our personhood is intri-
cately interwoven with our cultural identity. Edward Saour (1929) concurs
and states:

No two languages are ever sufficiently similar to be considered as representing

the same social reality. The worlds in which different societies live are distinct
worlds, not merely the same world with different labels attached. (p. 209)

How powerful are these differences and distinctions? Emotions are often
thought to be cross cultural; in our emotions, we are all equally and commonly
human. However, Gergen (2009) cites an Ifaluk example of an emotion called
54 Chapter 2

“fago” which calls this into question. Gergen argues that the Ifaluk use the
word to indicate compassion, sadness, admiration, and homesickness. Like
Saour, he concluded that the Ifaluk are actually feeling something different
than Westerners—not simply a Western feeling with an Ifaluk label.
With this brief discussion of an emotion that has no Western correlate,
Gergen supports his contention that emotions are culturally determined;
even when it comes to feelings, there is no solid shared affective reality that
bridges one culture to another. In this sense, when one accepts the idea that
different cultures equal different realities, then there is no longer a sense that
any particular reality is truly “real.” Given that every culture believes that
their own view is solid and implicitly superior to all other cultural views, no
culture can actually have an innate claim on the “true view” of reality. As
we deconstruct our cultural programming and assumptions, we can sense the
chaos that lies beneath our feet, the sense that everything could have been
different. Thomas Hylland Eriksen (2010) comments:

The single most important human insight to be gained from this way of compar-
ing societies is perhaps the realization that everything could have been different
in our own society—that the way we live is only one among innumerable ways
of life which humans have adopted. . . . Anthropology may not provide the
answer to the question of the meaning of life, but at least it can tell us that there
are many ways in which to make a life meaningful. (p. 327)

Understanding the implications of this sort of chaos, cultures take various

steps to protect their members from the deviant and competing worldviews
of other cultures. A culture cannot afford the idea that its view of reality—its
values, laws, standards, and mores—are simply created by a series of com-
plex and arbitrary interactions between geography, technology, history, and
so forth; instead, the culture is constrained to argue that it’s worldview has a
solid and indisputable basis. The worldview of a culture is always presented
as the “Truth,” the map that provides an accurate description of the territory.
In most cultures, this “map” is “holy” and contains the essential truths about
how it really is, the immutable laws about the nature of reality. Often this map
comes from a divine source; there are myths and stories about the role of the
Gods in the origin of the People. Sometimes there is a prophet who speaks
with the power of the divine; sometimes there is a covenant between God
and His People underlying the map. What is important is some documenta-
tion that the view of Reality is derived from or endorsed by a Higher Power.
Another way to infuse the cultural map with authority is the claim that it
is a much more accurate map of reality. Western cultural beliefs are superior
to indigenous cultures because science has generated a map that is superior
to the superstitious maps that came before. Capitalism is “proven” to be the
 Close Encounters with the Abyss 55

best way to motivate people to work together. And democracy is the “right”
way for people to govern themselves.
When subjected to basic psychological analyses, these arguments about
our map being “more accurate” or “derived from the one True God” simply
sound like an insecure person desperately seeking stability and validation.
Given this level of desperation, it is not surprising that the competing views
of other cultures are often labeled “insane.” This particular label not only
serves to protect extant cultural members, it simultaneously implies that
one might go crazy if she accepts a different view of reality. There’s a nice
example of this attribution of insanity from the blockbuster movie Avatar.
Jake, Avatar’s protagonist, is attempting to become a member of another cul-
ture. Most members of the indigenous culture are resisting this idea but the
shamaness becomes a somewhat unwilling supporter due to the occurrence
of certain spiritual signs. However, even with this support, note the nature of
her invitation to Jake:

“It is decided. My daughter will teach you our ways. Learn well, ‘Jakesully,’ and
we will see if your insanity can be cured.” (Cameron, 2009, emphasis added)

As mentioned above, from the perspective of a centered member of one

culture, the beliefs of another culture are literally “insane.” This fragment
of dialog illustrates just how threatening a competing view of Reality can be
and just how important it is not to be polluted by a competing Reality. Call-
ing something “insane” is a synonym for “absolutely dangerous,” “toxic if
touched,” “destructive if consumed.” The shamaness, at least, is deeply con-
vinced that an individual cannot be healthy—or, in some ways, be allowed to
exist—unless their heretical beliefs are purified.
Since we are discussing the need for a culture to defend itself against the
belief system of a competing culture, it is perhaps even more instructive
to review the reaction to Avatar, especially from the more conservative or
“Apollonian” segment of the media. There is a useful typology, originally
made popular in Western culture by Nietzsche, called the Dionysian/Apol-
lonian continuum. While these terms can be used variously by different
writers, for the purposes of this book Apollonian is defined as an orientation
toward what is ordered, lawful, responsible, self-sacrificing, future-oriented,
logical, rational, and structured. Dionysian refers to an orientation which is
spontaneous, present-oriented, hedonistic, creative, intuitive, and passionate.
Apollonian types accept authority, are comfortable in hierarchical systems,
and seek certainty from externals. Dionysian types promote ideas such as
“following your own wisdom or feelings,” internal authority, and being true
to oneself. Obviously, Dionysians are comfortable and even eager to embrace
change and Apollonians are distrustful and wary of change.
56 Chapter 2

James Cameron, the award-winning writer and director of the Hollywood

film, Avatar, contrasts two cultures: the first is a caricaturized version of a
capitalistic, post-industrial culture which sees the natural world as a place to
be exploited for its material wealth; the second is a technologically primitive
culture which, however, embraces and embodies a worldview where every-
thing is connected and interdependent. The story line is fairly predictable:
wounded hero meets princess from an innocent culture; they fall in love but
he makes mistakes which alienate him from his woman. He redeems himself
via an act of courage, then leads the fight where the pure but powerless cul-
ture—David—overcomes the rich but evil culture—Goliath.
Most viewers considered Avatar a cutting edge film in terms of special
effects and an entertaining retelling of one of the standard Hollywood themes.
Viewers rewarded it financially by making it the highest grossing film of all
time. However, in spite of all of those accolades and rewards, religious and
political conservatives attacked the film relentlessly. Epithets virtually rained
from the sky as the film was called variously “un-American,” “ungodly,”
“anti-capitalistic,” “anti-US military,” “anti-white,” “New Age,” “polytheis-
tic,” and a hundred other critiques. Many of these critical reviewers cautioned
readers against seeing it and especially cautioned the impressionable—young
people—against viewing the film.
While the attacks were partly due to the implicit liberal values espoused
by the film—Avatar is strikingly pro-environment and politically progres-
sive—the level of attacks was too high for a simple political or values
disagreement. There was a level of fervor in the attacks—a fervor perhaps
better characterized as terror; it felt like the conservative commentators were
fighting for their lives. It seems that the Apollonian critics fully agreed with
the shamaness in the film: Avatar espoused a worldview that was “insane,” a
worldview that was capable of destroying the consciousness of an unprepared
or immature viewer, a worldview capable of destroying “the American Way
of Life.”
Lest this seem like an overreaction from the conservative press, recall that
the whole point of this chapter is to point out the fragility of the Real. In
Avatar, Cameron was arguing that the worldview of the other culture—their
sense of reality—is superior to our own. Since the truth of one’s cultural
superiority—and the resulting stable sense of reality—is always delicate and
hanging by a thread, the conservatives were correct that Avatar was a dan-
gerous movie with a dangerous message. Of course, in truth this was simply
a movie and the competing culture was an invented fantasy. However, the
volume and ferocity of the attacks do imply that a real threat to the worldview
existed. And it is appropriate for a culture to defend itself vigorously when its
worldview is threatened.
 Close Encounters with the Abyss 57

Returning to the concept of the need of a culture to define itself as supe-

rior: as long as a culture considers itself the “apex” culture—and virtually all
cultures do in one way or another—that culture is immunized against reality
pollution from another culture’s worldview. When I believe that my cultural
viewpoint is more “advanced” than yours, my worldview is safe. Western
culture was safe in this manner throughout the end of the nineteenth century
and believed that its dominance could not be challenged by the inferior,
“primitive” cultures that formed its competition.

Figure 2.1 Edvard Munch. The Scream. Pastel on board. 1895. © 2012 The Munch
Museum/The Munch-Ellingsen Group/Artists Rights Society (ARS), New York.
58 Chapter 2

Figure 2.2 Two Tahitian Women. Gift of William Church Osborn, 1949 to The
Metropolitan Museum of Art. Public Domain.

With the advent of the twentieth century, that simple superiority began to
be challenged from many angles. Between 1893 and 1910 Edward Munch
painted a series of four impressionist paintings entitled The Scream. This
work embodied the alienation and suffering of modern man. As time went
on, it became a symbol for all Western suffering. Western life is good on the
surface but examine it more closely and one finds poverty, crime, world wars,
the Holocaust, the Depression, and Nuclear War. Hundreds of other writers,
 Close Encounters with the Abyss 59

social scientists, poets, and artists joined Munch in depicting the dark and
problematic side of Western culture. In sum, the implicit superiority of West-
ern culture began to show cracks around the edges; the simplistic confidence
of empiricism began to be threatened.
In 1928 Margaret Mead researched and wrote a book which was to become
the single most famous text in anthropology at the time: Coming of Age in
Samoa. This book affected Western culture in multiple ways; for purposes of
our argument, however, it was a credible and powerful discussion of the con-
cept that other cultures have the capacity to develop healthy human beings; in
fact, in some cases these humans are healthier than the equivalent members of
our culture. More specifically, it documented how Samoan culture was supe-
rior to Western culture in terms of sexuality, relationships, and the ability to
be present in life. This book, and the hundreds of subsequent books, pictures,
and research projects emphasizing ways in which other cultures are superior
to Western culture, fundamentally challenged facile Western assumptions
about dominance. The Gaugin painting to the right can be seen as symbolic
of these healthier alternatives to the Western way of being. This shifting of
consciousness is documented in the following quote from Lily King (2015).

Anthropology at that time was in transition, moving from the study of men
dead and gone to the study of living people, and slowly letting go of the rigid
belief that the natural and inevitable culmination of every society is the Western
model. (p. 36)

Munch, Mead, and all their compatriots did succeed at threatening the
superiority of Western culture. Of course, it is also true that Western culture
continued to argue for its position as the apex culture via references to two
important factors: its adherence to the scientific model and its dominance in
the area of technology. However, even with these outstanding factors, the
claim to be the apex culture was no longer undisputed. After the early twen-
tieth century, ethnology, cultural anthropology, and the daily life experience
of other cultures implicitly challenged the stability of our own worldview.
Our culturally derived sense of reality generally continues to feel solid but,
when examined, it is clear that it is built on sand. Its stability dissolves under
simple ethnographic analysis.
Modern anthropology demonstrates that all humans live in cultures based on
constructed realities. As Western culture evolved, doubts began to grow about
our identity as the apex culture and the sense of the fragility of our cultural real-
ity grew proportionally. The corresponding backlash against other cultures doc-
uments one way in which this growing fragility is experienced in the culture.
Most importantly, however, is the fact that any thoughtful and reflective reader
can feel the insubstantiality and ephemerality of our culturally created reality.
60 Chapter 2

DENIAL VERSUS DEPTH

Comfort is no test of truth. Truth is often far from being

comfortable.
—Swami Vivekananda, The Complete Works
of Swami Vivekananda (1907)

This chapter has focused on the existence of the Abyss, the Abyss as the
underlying reason for anxiety, and the Abyss as the explanation of the rapid
deterioration in psychological functioning seen so often in conjunction with
bad news. Becker tells us: “To live fully is to live with an awareness of the
rumble of terror that underlies everything.” This chapter has expanded Beck-
er’s focus on death by including two additional aspects of the Abyss. The
first demonstrates that the sense of Self is fragile and ephemeral; the second
shows that all culturally based views of reality are constructed and relative.
Death waits for us all and makes a joke of all we accomplish here. You, as
person, do not truly exist; you only “feel” you exist. Finally, everything you
have been taught and believe about reality is simply “made up”; it changes
from culture to culture. Death, no Self and no Reality: this is the nature of
the Abyss.
Living with these truths requires a level of denial. In this sense, denial can
be a wonderful thing. At the least, it can be highly functional. Most of the
clinical problems brought into therapy can be discussed and resolved with-
out direct reference to the Abyss; in fact, if the therapist insisted that every
dilemma be framed existentially, many clients would react with dismay,
distress, and rejection.
For therapists, however, denial is massively counterproductive. If a thera-
pist is in existential denial, how can she fully understand client depression
or anxiety? This, of course, is the old argument of existential psychology;
unless a therapist has the depth to face and integrate her own existential ter-
ror, she will be handicapped when it comes to helping a client with his terror.
It is possible to ignore this existential argument when psychology believes
that techniques have power. From this point of view, any well-trained thera-
pist can successfully employ effective techniques; personal depth might be
helpful but it is not required. However, when techniques have no inherent
power—and the focus shifts to the charisma of the therapist—the existential
argument gains new credibility.
To make this sense of the Abyss more concrete, Yalom offers an example
of a client with a recurring nightmare.

Another patient had a recurrent nightmare that dated back to early childhood
and now, in adulthood, resulted in severe insomnia—in fact, in a sleep phobia,
 Close Encounters with the Abyss 61

since he was terrified of going to sleep. The nightmare is unusual in that the
dreamer himself suffered no harm. Instead, his world melted away, exposing
him to nothingness. The dream:
I am awake in my room. Suddenly I begin to notice that everything is
changing. The window frame seems stretched and then wavy, the bookcases
squashed, the doorknob disappears, and a hole appears in the door which gets
larger and larger. Everything loses its shape and begins to melt. There’s noth-
ing there any more and I begin to scream. (Yalom, 2008, Kindle Locations
4994–4998)

Or take this second example from Kurt Reinhardt.

Something utterly mysterious intervenes between him and the familiar objects
of his world, between him and his fellowmen, between him and all his “values.”
Everything which he had called his own pales and sinks away, so that there is
nothing left to which he might cling. What threatens is “nothing” (no thing), and
he finds himself alone and lost in the void. But when this dark and terrible night
of anguish has passed, man breathes a sigh of relief and tells himself: it was
“nothing,” after all. He has experienced “nothingness.” (Yalom, 2008, Kindle
Locations 5045–5048)

Without understanding the Abyss—without being in dialog with the primal

terror inherent in chaos and death—the therapist will never completely under-
stand the power of constructed reality. Constructed reality is built on the
foundation of the Abyss. When cultural conditioning and all programming
are deconstructed by mindfulness and discernment, the philosopher arrives at
the edge of the Abyss.
The Abyss in not simply a foundation, it is a dynamic force. It is appropri-
ate to state that constructed reality is in dialog with the Abyss. The Abyss
is always attempting to break through the shelter of constructed reality. In
fact, these Abyss “breakthroughs” are often seen as the source of psychopa-
thology; certainly Carl Jung and James Hillman make such breakthroughs
central in their models. Paradoxically, both Jung and Hillman also argue that
the Abyss can have an opposite effect; the right type of interactions with the
Abyss can lead to inner peace and wisdom.
In sum, even though psychologists may not directly discuss the Abyss
with clients on a daily basis, they need to be comfortable with its presence to
understand anxiety, decompensation, and existential issues. This familiarity
has always been necessary but it is even more important once it is understood
that techniques lack inherent power. Constructionists need to understand the
Abyss to understand the nature of constructed reality. Indeed the fluid and
ever-changing dialog between Abyss and culture—between mortality and
self—creates the milieu for psychotherapy. Finally, denial may be functional
62 Chapter 2

at certain times for individuals and for the culture in general; however, it has
little utility for therapists who want to enhance outcomes. The Empire Strikes
Back tells us:

LUKE: I’m not afraid.

YODA: Ohhh . . . you will be, you will be. (Lucas & Kershner, 1980)
 Chapter 3

Social Constructionism

All that we see or seem

Is but a dream within a dream.
—Edgar Allan Poe, “A Dream Within a Dream,” 1849

Social constructionism is a relatively new discipline with roots in a variety

of approaches including philosophy, sociology, psychology, ethnology, and
literature. It is fairly easy to define. The “constructionism” part of the term
refers to the idea that reality is constructed not discovered. The “social” part
refers to the idea that these created realities are supported, affirmed, and
reconfirmed in every social interaction with another member of the same
culture.
It is easy to illustrate some of the main ideas of constructionism with a
simple picture.
This is a picture of a cliff randomly shaped by time and erosion. Imagine
you walk past it and do not notice anything special—just another rock out-
cropping. However, the next time you pass by, you are with a friend who
remarks that the cliff is actually a sculpture of a face or perhaps the mask of
an ancient God. From that point forward, it will be very difficult for you to
ever see it as just another rock outcropping.
The first question has to do with discovery versus construction or creation.
Since we know that the outcropping was formed randomly, it is obvious that
the “face” was not “discovered”; rather it was constructed by the pattern-
creating part of the mind. This process, which is formally called Pareidolia,
is operated by Kahneman’s System 1. After one has seen the cliff as a face,
it will be difficult to see it as a random outcropping again. There is a sense
that the face “really exists.” And, since it was first experienced in a social
context, and your friend also has the sense the face “really exists,” there
63
64 Chapter 3

Figure 3.1 Photo Credit: https://weirdtwist.wordpress.com/2012/11/13/faces-in-rocks/.

is social reinforcement about viewing reality this way. Hence, we have the
Social Construction of Reality which is, of course, the title of Berger and
Luckmann’s famous book.
Note how easy it is to deconstruct this creation. Simply cover the upper
part of the photo (the nose and eyes) and the face disappears and all that is left
is a randomly eroded rock outcropping. In sum, constructionists believe that
“reality” is essentially random—the Abyss. Until we bring the focus of Sys-
tem 1 onto it, it remains chaotic and unorganized. Once System 1 perceives
a pattern, reality is constructed into whatever pattern has been projected onto
it. This pattern has a great sense of solidity and truth; even though there is no
essential “face” in the rock, it feels as if there is. This realness can be greatly
enhanced if we get another person—or the entire culture—to agree that this
 Social Constructionism 65

is the way we are going to perceive this rock outcropping. Finally, with the
right methodology, the construction can be deconstructed and the perceived
object (or idea) dissolves back into random and chaotic material.
Frankly, it is always difficult to believe that constructionists are actually
arguing what they are arguing. Can they really be serious when they say that
we have created everything, that it is all, in the end, just invented? However,
an examination of the following quote from Vivian Burr, a leading social
constructionist, shows just how serious she is about the provocative implica-
tions of her ideas.

Since the social world, including ourselves as people, is the product of social
processes, it follows that there cannot be any given, determined nature to the
world or people. There are no essences inside things or people that make them
what they are. . . . It is important to stress the radical nature of the proposal that
is being put forward here. (Burr 2003, 5–6)

Later in her book, she expands this point further.

Social Constructionism, then, replaces the self-contained, pre-social and unitary

individual with a fragmented and changing, socially produced phenomenon who
comes into existence and is maintained not inside the skull but in social life.
(Burr, 2003, p. 104)

Burr and the other constructionists are literally saying that “it’s all made up.”
Our culture is invented; our identity is the process of negotiation between
ourselves and others; and the specter of our inevitable death creates an under-
lying sense of anxiety that motivates us to reify the constructs. It only seems
real because everyone around us has an implicit agreement with us to act like
it is real. It is the Emperor’s New Clothes on steroids.
Look at the quotes above. Burr is saying that reality is essentially a cha-
meleon, capable of shifting into whatever form we collectively desire—what-
ever we choose through consensus. And then the magic occurs. Once we
agree on the form, due to System 1’s ability to imbue worldviews with a sense
of permanence, we will all have a shared “gut” feeling that our invented real-
ity is solid. Of course, in truth, this agreement never really changes the nature
of the world; it continues to be a fluid, fragmented and changing medium that
takes shape briefly and then collapses again into the raw building blocks of
chaos. The constructionists are essentially arguing that life is more akin to an
LSD experience of fluidity, hallucination, and dissolution than the commonly
accepted reality of routine, expectations, conventions, and solidity.
The full implications of this viewpoint are profound and difficult to under-
stand and accept; however, it is relatively easy to understand a limited con-
structionist view when it comes to social roles. Any educated person knows
66 Chapter 3

that, for example, a woman’s sexual attractiveness varies according to which

culture she inhabits and which historical period. Burr (2003) comments:

It is often pointed out that, a couple of hundred years ago, a woman of ample
proportions and pale skin was the epitome of desirable femininity. The change
to today’s preference for a slender, tanned body is hard to understand within
the view of sexuality as hard-wired and fixed but makes a good deal of sense
once we locate sexuality within a socially shared meaning system that is inti-
mately bound up with social structure and the economy. In times when access
to the material resources for sustaining life was perhaps even more divided by
class than today, a well-fleshed body, who skin declared that its own had never
needed to toil in the fields, spoke of wealth and comfort. (p. 43)

This knowledge that our collective sense of sexual attractiveness is socially

constructed is relatively easy to absorb. Next, Burr (2003) takes us another
step further and asks us to look at “motherhood,” a concept where it is more
difficult to discern the social constructions. In the following quote, Burr looks
as the definitions of “good” versus “bad” motherhood and resulting feelings
of depression, empowerment, and choice.

A woman may complain of depression, feeling that she cannot cope with her
life. Perhaps she feels that she is a bad mother because she frequently loses
her temper with her young children, or that she is an inadequate daughter
because she is reluctant to care for her own elderly mother. But in re-casting the
problem at a societal level rather than at the level of the individual a different
analysis emerges. Such an analysis may suggest that the woman sees herself
as oppressed rather than depressed. The discourses of motherhood, femininity,
family life and so on actively encourage women to engage in practices which are
not necessarily in their own psychological, social and economic best interests.
Thinking of oneself as oppressed rather than depressed fosters a different view
of oneself. (p. 122)

Social constructionists can get truly radical when they argue that feelings
themselves do not arise internally from an essential self but rather exist in the
space between people. In the following quote, Gergen cuts to the heart of our
sense of self by arguing that internal feelings and the sense of an “inner life”
was essentially invented (constructed) only a few hundred years ago.

It was only in the following century (the 1700’s) that people began to construct
themselves as having “feelings.” And, over the centuries that followed, we have
steadily increased the number of events and processes that we attribute to the
mental world. It is now estimated that in English we have over 2000 words
referring to the inner world of the self. Is it not totally clear to us today that each
of us has thoughts, emotions, motives, desires, wants, needs, ideas, will-power
 Social Constructionism 67

and memory? To be without these ingredients of the mind, we would be some-

thing less than human. (Gergen, 2009, p. 82)

Of course, what Gergen is arguing here is that these “ingredients of the mind”
which we define as essential to being human simply didn’t exist in Western
culture prior to the 1700s and don’t exist in a number of other cultures both
historical and current. This is such a radical concept to any modern West-
erner—especially mental health professionals—that it is almost unthinkable.
Who would I be if I didn’t understand myself in terms of my feelings and my
inner life? How do people in other cultures and time periods have a sense of
self without these reference points?
This final point was illustrated by my own experience at a workshop with
Joseph Campbell in the 1980s. During this workshop, which was organized
around the Tristan and Isolde myth, Campbell made the provocative statement
that the primary contribution of Western culture was the invention of the concept
of romantic love. This statement rocked my sense of reality. I tried to imagine
a culture where “falling in love” was not a central experience of being human.
Of course I had heard long before about arranged marriages, and imagined what
it might be like if one only had a choice of three females from the adjoining
tribe of hunter/gatherers, but actually letting in that most human cultures have
functioned without the concept of romantic love literally made me feel unstuck
and adrift. Romantic love was so central to my own sense of identity that the
idea of operating without it made me feel a bit like Sartre, a bit nauseous.
Social constructionists refuse to limit their analyses to social roles and
psychological feelings; they insist that the power of constructionism extends
to basic processes such as illness and pain. Gergen (2009, p. 105) points out
that athletes in the midst of a competition experience little or no pain even
when sustaining major blows and broken limbs. Soldiers who see a wound
as a ticket to safety often experience euphoria instead of pain when injured.
Women in certain other cultures—for example, Micronesia—have so little
labor pain that doctors can only identify contractions with a hand on the abdo-
men. Finally, deeply religious individuals, when attempting to identify with
the “passion of Christ,” experience pain as an elevated spiritual rapture. In
sum, pain is much more constructed than might be expected.
I can easily imagine getting euphoric about pain when a wound is a pass-
port to get out of the danger of war; I had already met a number of veterans
who had this exact experience and it seemed credible to me. Moreover, I had
personally experienced the level of pain control embodied in the athletic ref-
erences. I was shocked, however, to imagine that Micronesian women live in
a reality that precludes contraction-related pain during childbirth.
In sum, the Social constructionists are intent on exposing the chaotic
and arbitrary nature of the world that underlies our seemingly solid and
68 Chapter 3

consensually supported worldview. They want to strip away the easy assump-
tions and the safe and stable models and replace them with an awakened
consciousness that cuts through assumptions and social programming. In the
right person, this increase in consciousness can be stimulating and liberating.
For an individual who is less sure of herself, exposure to such ideas can be
terrifying and destabilizing.

SCIENCE AND POSTMODERNISM

One hears only those questions for which one is able to find
answers.
—Friedrich Nietzsche, The Gay Science (1882)

Social constructionism is not content with helping the individual understand

the degree to which his daily experience and cognitions are socially con-
structed; it also critiques the shared worldviews of the culture and specially
focuses on assumptions related to meaning and progress. To understand what
the constructionists are critiquing, it is important to review the evolution of
meaning over the last 500 years of Western culture.
More specifically, from the standpoint of implicit meaning and authority,
Western culture can be divided into three periods: 1) pre-modern (from the
beginning of the historical record through Galileo), 2) modern (from Galileo
through World War I), and post-modern (World War I through the present).
Pre-modern Western culture derives its authority and validity from revelation
as documented in the scriptures and as interpreted by religious authorities.
Modernism is identified with empiricism and science; progress, meaning, and
ultimate truth will be attained by rationality and scientific discovery. Post-
modern Western culture believes that whether there is ultimate truth or not,
humans can’t attain it in a pure form; instead, there are personal, functional,
and relative truths. Authority is based on inner experience and existential
choices.
Obviously constructionism is one of the leading components of postmod-
ernism. And, just as empiricism criticized the authority of the church and its
revelation, constructionism offers its critiques on the power and authority
of science. In order to appreciate the constructionist critique of science, it is
important to understand that what we call “science” needs to be divided into
two parts. The first part, which for this discussion can be called “functional
science,” has to do with creating maps and models about fundamental reality
and about making things work. The second part, which can be called “faith-
based science,” has to do with science’s authority and its “promise” of hap-
piness, security, and abundance in the future.
 Social Constructionism 69

The benefits of functional science are easy to describe and understand.

Humans are adaptive and have been highly motivated and successful through-
out history in terms of developing enhanced technologies which contribute
to our security and comfort. The invention of metal tools, the domestication
of the horse, and developments in architecture and ship building all occurred
before the articulation of the scientific method, yet they all embody the high-
est level of creativity, problem solving, hard work, and perseverance. To
make anything work, or work better, one needs to observe phenomena, come
up with a theory about it, test the theory, and then modify the theory based
on the results. Science did not invent this method; it is inherent in figuring
anything out or developing any technology.
The faith-based aspect of science is more subtle and more difficult to
understand. Recall that the popular articulation of the scientific model was
created by eighteenth-century empiricists. These empiricists had a fairly
straightforward view of the universe. They saw it as a complicated machine
that could be taken apart and understood via hard work and rational thought.
The fruits of understanding this complicated machine would include cheap
energy, advanced technology, increase in wealth, improved social justice and
a decrease in poverty, control of disease, and an extended life span. They had
not heard of the uncertainty principle, chaos theory, and the fact that Schro-
dinger’s cat can be simultaneously alive and dead. They certainly would have
agreed with Einstein’s famous quote: “God does not play with dice.”
Kahneman would probably point out that this empirical theory of the uni-
verse was almost certainly generated by System 1 and then justified by Sys-
tem 2. System 1 loves the idea that the universe is some kind of immensely
complicated mechanism whose laws can be discovered and whose principles
can be mastered. This theory has all the characteristics that System 1 is drawn
to: it is simple, comprehensive, and makes the future predictable and safe.
Remember that System 1 is so seductive and powerful that even sophisticated
and educated members of Western culture—who also might intellectually
understand uncertainty and chaos—will find it hard to reject this simplistic,
mechanistic model of the universe.
It is also important to note that for the modern layman, faith-based science
is structured in a manner which is highly similar to the structure of premod-
ern religion. The first similarity is that the view of the universe espoused by
the seventeenth-century empiricists is no more accurate—and just as faith
based—as any religious claims of the nature of reality that are derived from
revelation or scripture. The empiricists simply advanced a theory which
seemed reasonable to them and that theory—because it has been endorsed by
virtually every member of the culture—seems like an accurate description of
the universe. It has become reified in the cultural consciousness. Almost all
Westerners “implicitly believe” that the universe is a complicated machine,
70 Chapter 3

that science is making significant progress in figuring it out, and that “some-
time in the future” the machine will be fully mastered and all of the promises
of science will come to fruition.
The second similarity between science and religion is the idea of a priestly
caste—a group of special people that are closer to God than normal people.
These are people that can intercede with the divine, provide guidance to lay
people, and ultimately hasten our arrival at the final goal. They speak a spe-
cial language indecipherable to the common man and have powers and abili-
ties beyond the norm. There is a humorous reference to these concepts of a
priestly case from Duck Breath Theatre who popularized these ideas in their
famous NPR comedy sketches featuring “Dr. Science.” The introduction to
the show always began with:

“He knows more than you do.” (because he has) “a Master’s Degree . . . in
science!”

Similarly, at the end of Raiders of the Lost Ark, Indiana Jones is assured that
the ark, with all of its divine power, is in safe hands because:

Maj. Eaton: We have top men working on it now.

Indiana: Who?
Maj. Eaton: Top . . . men. (Marshall & Spielberg, 1981)

Like priests speaking Latin, scientists speak a special tongue unavailable to

the common man. They make pronouncements and predictions that cannot be
understood by the lay person because of a lack of training and innate ability;
instead they need to be accepted on faith. This special status is internalized
in the culture through common use phrases such as “it doesn’t take a rocket
scientist to figure this out.”
They are particularly trusted because they have a “sacred” method that
ensures their leadership is free from blemishes: they have taken “vows” to be
rational and impartial and to use the objective scientific method that ensures
fairness and purity. In fact, the term “scientific” has become synonymous
with rational, impartial, trustworthy, and reality based. People may lie but
science is innocent and pure.
Recall what we expect from science—what are its implicit promises?
Because of science, someday we will travel to the stars. We will eventually
vanquish all disease and increase the lifespan. There will be abundant free
energy and advanced technologies that will lift everyone out of poverty and
ensure justice and peace for all mankind. All mental health disorders will be
cured and human conflict will be minimized. If this sounds like the Garden
of Eden or a terrestrial version of Heaven, the similarities are not accidental.
 Social Constructionism 71

The faith-based aspects of science and modernism bear striking similarities

to the promises of religion and premodernism. There are assumptions about
the nature of the universe that must be taken on faith and never questioned;
there is a priestly caste of gifted and semi-divine people who will facilitate
our arrival at the final goal and who can be trusted to solve all problems; and
there is the eventual outcome of reestablishing the Garden of Eden on earth.
Constructionists making such an argument about the implicit values and
structure of science are usually attacked on three fronts. The first is the con-
cept that in premodern cultures, the religious authorities hinder the advance-
ment of knowledge by forbidding inquiry into areas that threaten the religious
worldview. Copernicus and Galileo are often cited examples. However, it is
not hard to counter this by pointing out that people in power in every culture
always have a vested interest in controlling the evolution of technology and
knowledge. Current examples include the “science” around the health risks
of tobacco or the validity of climate change.
And in the area of medicine and mental health, there are numerous exam-
ples of the control of the evolution of knowledge. For example, pharmaceuti-
cal companies have paid the most prestigious physicians and journal editors to
endorse their products and approaches and have controlled the direction of sci-
entific research simply by funding one approach and defunding another. Even
the “impartial and rational” scientific method has been manipulated by power-
ful members of the culture. A recent article (Lexchin, Bero, Djulbe, & Clark,
2003) found that double blind studies of new medications were 30 percent
more likely to find significance if the studies were funded by the pharmaceuti-
cal company that developed the drug versus independent investigators. How
did the funding source affect the purity implicit in the double blind model?
The second critique of the constructionist position is more compelling:
“How can one doubt the efficacy and power of science when: 1) it has
achieved all these advances and 2) each piece of knowledge builds on previ-
ous discoveries?” The worth of science is validated by the wonderful things it
has created and the body of knowledge that has been developed. The internet
and antibiotics prove that science is powerful and effective.
The key to responding to this critique is to separate the implicit human
desire to adapt, create, and make one’s life easier from the faith-based aspect
of science. One can understand this most easily by examining the same
claims from the vantage point of a premodern culture. For example, when
Cortes arrived in Mexico with the intention of conquering the country for the
Spanish king, he made almost identical claims that his technology validated
his philosophy and religious beliefs. When he approached a native tribe, he
would tell them that they should submit to him and his God because all of his
advanced technology—ships, guns, armor, etc.—was the result of worship-
ping the one true God. He never claimed that his culture had these advanced
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technologies because they had been lucky in their geopolitical fortunes, or

had a fruitful interaction with the Orient or because humans are generally
adaptive and inventive. Cortes truly believed that his culture’s advanced
technology was due to the Grace of his God. Similarly, modern technologi-
cal advances are simply the next stage of technological innovation and are
not due to the vision of seventeenth-century empiricists that the Universe is
a complicated machine.
The final argument is based on the concept that science promotes rational-
ity and rationality will eventually unlock all the secrets of the universe. This
is an appealing idea if one accepts the idea that “God does not play with
dice” and that there are simple cause-and-effect connections in the Universe.
Unfortunately it seems that the closer we examine the universe, the less it
appears to follow simple cause/effect rules. Consider the following quote by
Moreno (2012) about the futility of applying a simple Enlightenment model
to modern scientific challenges.

By the late 19th century some philosophers theorized that, given enough time
and money, the scientific community would be able to come up with a unified
system of knowledge of the whole of reality. That endpoint may never actually
come, of course, but it was the product of a thought experiment about the dem-
onstrated power of actual experiments, a kind of ideal terminus of knowledge.
Certainly the Darwinian revolution give reason to believe this could be done in
the biological world, and even today physicists are aiming for unified theory of
the cosmos.
But what we seem to be discovering is that, as we dig into the weeds of
the nature of reality, reality is ever more stubborn about giving up the secrets.
Nowhere is this recalcitrance more apparent than in genetics and neuroscience.
The more we learned about the human genome, the more important proteins
of turned out to be, and the more we learned about brain cells, the more we’ve
realized how important the connection between brain cells are (something the
philosopher and psychologist William James told us in 1890!).
. . . Just to take the case of neurological disorders like autism, it’s quite clear
that like cancer, the conditions brought under that large rubric have diverse
biological roots. A couple of years ago a well-known geneticist told me that he
is sure Asperger’s syndrome is genetically quite distinct from the spectrum of
autism disorders, for example. So, again, it’s often the case that the next step
gets harder and more expensive. At the same time, the external variables that
cause multiple genetic switches to be turned on and off are so numerous, subtle
and hard to control that few disease risks can be confidently predicted. Even
“designer babies” wouldn’t change that. (Moreno, 2012)

This is a new way of seeing. The universe does not appear to be a complex
machine which can be disassembled and understood via sufficient rational
study and experiments. Rather it is a fluid, dynamic system marked by chaos
 Social Constructionism 73

and unpredictability that resists rational explanation and control. Michael

Crichton, in his well-known movie, Jurassic Park, took on this exact ques-
tion. In the movie, geneticists have recreated dinosaurs from recovered DNA
and the park developer has brought in independent scientists to review the
park before opening it to the public. One of the scientists is an advocate of
Chaos Theory and Crichton uses the plot and the dialog to contrast a rational-
istic scientific view with a view influenced by chaos theory; in other words,
he creates a dialog between the modern perspective and the postmodern.
Examine the following quotes from the “chaostician” brought in to review the
park and note his disparagement of the empirical model of reality.

Dr. Ian Malcolm: Gee, the lack of humility before nature that’s being displayed
here, uh . . . staggers me.

Later in the film, as all parties recognize the limitations of rational control
over nature, that is, the dinosaurs have gotten loose and are killing people,
the chaostician continues.

Dr. Ian Malcolm: God help us; we’re in the hands of engineers.
Dr. Ian Malcolm: [realizing that the park is out of control] Boy, do I hate being
right all the time! (Kennedy & Molen [Producers] & Spielberg [Director], 1993)

Constructionists make a powerful case undermining the innate assumptions

of faith-based science. In actuality, science gets much of its credibility from
System 1’s “will to believe” and most of the rest of it from its archetypal and
structural identity with religion. With science deconstructed, modern man is
both more free to perceive reality from any perspective and more prone to
experience the raw sense of an underlying chaos. While this can be terrify-
ing, it also frees up opportunities for fresh approaches to thinking, creating,
and innovating.

CONSTRUCTIONISM AND PSYCHOLOGY

God had created the world in play.

—Ramakrishna, The Gospel of Sri Ramakrishna (1910)

Kenneth Gergen is perhaps psychology’s leading exponent of construction-

ism. From that perspective he actively critiques many of psychology’s basic
assumptions. One of his primary critiques is nosology; Gergen is clear that
diagnosis in mental health is far more suspect than diagnosis in medicine.
Perhaps the single most famous diagnostic category “embarrassment” was
74 Chapter 3

the American Psychiatric Association’s 1974 debate on homosexuality. Prior

to this meeting, homosexuality had been considered a mental illness and it
had its own diagnostic category. By a vote of 5854 to 3810, this category
was removed and millions of Americans were “cured” overnight (Madigan,
2012, p. 966). If the vote had been a bit different, homosexuals would still be
considered mentally ill, a conclusion that in the present would be considered
absurd. Both the current sense of “absurdity” and the pre-1974 categorization
as “illness” illustrate the constructed nature of diagnoses.
Gergen tends to focus on the proliferation of diagnoses from the several doz-
ens in Diagnostic and Statistical Manual of Mental Disorders I (DSM I) to the
hundreds in the DSM V. More specifically, Gergen (2009, pp. 48–49) points
out that the increase in the number of diagnostic categories is almost perfectly
correlated with the number of practicing mental health professionals. The more
mental health professionals, the more diagnoses. Is this increase in categories
due to careful scientific discovery of underlying mental health structures or is
the increase due to mental health professionals attempting to expand their mar-
ket and enhance the power of their guild? Every new DSM release gives rise to
the question “do the new categories pathologize normal human functioning?”
Of course, once these categories are created they become self-sustaining.
First, practitioners invent the categories and “market” them to clients. Cli-
ents hear about the new category and start organizing and reporting their
symptoms in the new context. This leads other mental health professionals to
endorse the new category and so on ad infinitum. We are not discovering a
new diagnostic category, we are creating it.
Nosology in mental health illustrates the arbitrariness of psychopathol-
ogy. Are there really 20 categories of mental illness, or 60, or 300, or 600?
The only correct answer is that there are as many as the DSM committee
believes there are and that number is not based on any independently verifi-
able foundation. In medicine, an X-ray confirms a broken bone and a blood
test confirms diabetes; but there are no such real world correlates with mental
health diagnoses.
And the systems of psychotherapy are also based on similarly invented
constructs. Let us take the basic psychodynamic belief that current dysfunc-
tional behavior is secondary to a past trauma. The response to this trauma
forms a “complex” which must be removed by revisiting the past experi-
ences and working through them. To the psychodynamic therapist, these are
real events that caused real traumas. They are not imaginations or invented
memories. However, what if the psychodynamic therapists are not working
with real events from the past but instead are working with co-created con-
structions of the past?
Gergen (2009, pp. 40–41) particularly cites the work of Donald Spence,
the author of Narrative Truth and Historical Truth. Essentially Spence
 Social Constructionism 75

argues that the past that is recreated is not the actual, historical past. Rather,
the therapist and the client have worked over the past and developed a new
memory which is more conducive to problem resolution and future growth.
Apparently resolving the invented trauma is as conducive to change as resolv-
ing the historical trauma.
While this may lead to a desirable therapeutic outcome, it raises significant
questions. Can psychology be a science, based on facts and observations that
can be independently confirmed by separate practitioners, if it argues that
what really happened in the past is not the sine qua non of healing. Can the
science of psychology afford to accept the idea that the key to healing is what
the client feels and believes occurred in the past, not what actually occurred?
Irvin Yalom argues that the question is moot: the historical past has escaped
all of us long ago.

Psychoanalytic revisionists make an analogous point and argue that reconstruc-

tive attempts to capture historical “truth” are futile; it is far more important to
the process of change to construct plausible, meaningful, personal narratives.
The past is not static: every experienced therapist knows that the process of
exploration and understanding alters the recollection of the past. In fact, current
neurobiological research tells us that every time we access an old memory we
automatically alter it according to our current context, and the revised memory
is then returned to long-term storage in place of the original memory. (Yalom
& Leszcz, 2008, p. 187)

This description of how analytic therapists co-create a constructed past

and then heal it can be applied to other psychological systems. Cognitive
therapists elicit (co-create) irrational beliefs and then replace them with more
functional ones. Systems therapists co-create an existing description of a
family system that they define as dysfunctional and then create an alternative
that allows the identified patient and, hopefully, the family to move to a more
healthy and empowered position. Equivalent arguments can be made for the
other schools of psychotherapy. In sum, Gergen is arguing that a therapist
following any psychological system begins by co-creating a pathological
world and then replaces it with a more functional one. From this point of
view, every psychological system is essentially reframing—an initial frame
that defines the origins of pain and pathology and a subsequent frame that
provides relief and resolution. And, clearly, all of the differing frames are
constructed and co-created; in fact, the variability between the systems—and
the fact that they all work—exposes certain important principles that underlie
the research results.
Integrating the two research findings—that therapy works but that tech-
niques have no inherent power—can be confusing. We know that knowledge
of specific techniques don’t add to therapeutic efficacy because if they did,
76 Chapter 3

therapists trained in techniques would be superior to untrained therapists,

therapists who have practiced techniques for long (experienced) should be
superior to the less experienced, and some techniques (psychological sys-
tems) should be superior to others. Since none of these statements are true,
knowledge of techniques does not add to therapeutic efficacy.
But something happens between client and therapist during the therapy
hour; they discuss something and they have interactions and all of these
experiences can be mistaken for techniques. In fact, that is the classic error
made by most therapists: I performed a technique and, since the therapy had
a positive outcome, my technique must be responsible for the results. How-
ever, the preceding discussion documents that “what happens” is constructed,
co-created, and highly variable. It doesn’t matter what frame is offered, as
long as the client is invested in the frame and the therapist is seen as cred-
ible. Therapeutic reality is so constructed that the client will improve even if
offered wildly divergent ideas of why they are suffering from “you are the
identified patient in your dysfunctional family system,” to “your symptoms
are the results of trauma in your childhood,” to “you need to replace your
irrational assumptions about self and the world with rational ones.”
Fully accepting that “techniques lack inherent power” is not simply
accepting the research results, it means accepting that what masquerade as
techniques are an infinite variety of constructed realities limited only by the
investment of the client and the creativity and respectability of the thera-
pist. The positive effect is achieved by the relationship and the process of
constructing and deconstructing worldviews; it is not achieved by applying
scientific principles to fundamental reality.

CROSS-CULTURAL PSYCHOLOGY AND DEVIANCY

If God did not exist, it would be necessary to invent him.

—Voltaire, Familiar Short Sayings of Great Men (1887)

Other constructionists have taken Western mental health concepts to task from
a cross-cultural point of view. The most serious critiques argue that Western
mental health is simply another form of cultural imperialism. Consider the
following description of the worldview of a Maori from New Zealand:

For the Maori, the person is invested with a particular kind of power, called
Mana, which is given to the person, by the gods, in accordance with their fam-
ily status and birth circumstances. This Mana is what enables the person to be
effective, whether in battle or in their everyday dealings with each other. This
power, however, is not a stable resource, but can be enhanced or diminished by
 Social Constructionism 77

the person’s day-to-day conduct. For example, their power could be reduced
if they forget one of the ritual observances or commit some misdemeanor. A
person’s social standing, their successes and failures and so on, are seen as
dependent upon external forces, not internal states such as their personality or
level of motivation. For the Maori, accounting for oneself in terms of external
forces such as Mana means that all mental life and subjective experience will be
read off from this framework. (Burr, 2003, p. 138)

This worldview is radically different from the psychodynamic emphasis on

the importance of childhood trauma or the cognitive behavioral assumptions
about emotional distress resting on cognitive misconstruals. Given the seem-
ingly radical (to Westerners) Maori worldview and how it differs from the
standard psychological systems, is it any wonder that a Maori would make
the following critique of the usefulness of a Western map of mental health.

Psychology . . . has created the mass abnormalization of Maori people by virtue

of the fact that Maori people have been . . . recipients of English defined labels
and treatments. . . . Clinical psychology is a form of social control . . . and offers
no more “truth” about the realities of Maori people’s lives than a regular reading
of the horoscope page in the local newspaper. (Lawson-Te, 1993, pp. 25–30)

What makes the frames, theories, and typologies of psychology superior

to those of indigenous peoples? Is there evidence that our ideas of mental
health produce healthier young people, or adults who are more centered and
grounded, or seniors who are more connected to the culture? Moreover, are
the Western maps of symptoms and causes sufficiently robust to operate
across divergent cultures?
Berger and Luckmann explicitly believe that the Western map of mental
health breaks down when it is applied cross culturally. To make their point,
they argue that mental health symptoms differ so profoundly across cultures
that one culture’s “symptom map” looks silly from the perspective of another.
Of course, in making this argument, they not only caution against applying
Western mental health maps to people from another culture, they also use the
cultural variability of symptoms as further proof that mental health symptoms
are culture-specific. And, if the psychological systems are culture-specific
they must be constructed.

The rural Haitian who internalizes Voudun psychology will become possessed
as soon as he discovers certain well defined signs. Similarly, the New York
intellectual who internalizes Freudian psychology will become neurotic as
soon as he diagnoses certain well-known symptoms. Indeed, it is possible that,
given a certain biographical context, signs or symptoms will be produced by
the individual himself. The Haitian will, in that case, produce not symptoms
78 Chapter 3

of neurosis but signs of possession, while the New Yorker will construct his
neurosis in conformity with the recognized symptomatology. This has nothing
to do with “mass hysteria,” much less with malingering, but with the imprint of
societal identity types upon the individual subjective reality of ordinary people
with common sense. (Berger & Luckmann, 1967, p. 179)

Constructionists believe that it is easy to demonstrate the culturally bound

nature of psychological maps and constructs. If the psychological maps are
ethnocentric, what right do Western mental health experts have to assert that
their maps are an independent and scientifically based description of human
functioning versus Western cultural imperialism? Medicine argues that its
principles apply to all human bodies, can psychology claim the same?
In their own attempt to examine psychology from a cross-cultural point of
view, Berger and Luckmann suggest that there is a need for “psychological ser-
vices” in every culture. However, in this statement Berger and Luckmann are
not endorsing the universal healing or empowering nature of Western psycho-
logical services. Instead, in the quote below, they argue that psychotherapy has
the primary purpose of helping reprogram or recondition people who are devi-
ant—people who are having problems achieving functional roles in the culture.

Therapy entails the application of conceptual machinery to ensure that actual or

potential deviants stay within the institutionalized definitions of reality, or, in
other words, to prevent the “inhabitants” of a given universe from “emigrating.”
It does this by applying the legitimating apparatus to individual “cases.” Since,
as we have seen, every society faces the danger of individual deviance, we may
assume that therapy in one form or another is a global social phenomena. Its spe-
cific institutional arrangements, from exorcism to psychoanalysis, from pastoral
care to personnel counseling programs, belong, of course, under the category
of social control. What interests us here, however, is the conceptual aspect of
therapy. Since therapy must concern itself with deviations from the “official”
definitions of reality, it must develop a conceptual machinery to account for
such deviations and to maintain the realities thus challenged. This requires a
body of knowledge that includes a theory of deviance, a diagnostic apparatus,
and a conceptual system for the “cure of souls.” (1966, pp. 112–113)
Successful therapy establishes a symmetry between the conceptual machin-
ery and its subjective appropriation in the individual’s consciousness; it re-
socializes the deviant into the objective reality of the symbolic universe of the
society. There is, of course, considerable subjective satisfaction in such a return
to “normalcy.” The individual may now return to the amorphous embrace of his
platoon commander in the happy knowledge that he is “found himself,” and that
he is right once more in the eyes of the gods. (1966, p. 114)

One can read this statement as a delegitimizing of psychology—an argument

that the primary goals of psychology are related to social control instead of
 Social Constructionism 79

personal growth and maximizing human potential. Naturally this argument

makes a great many therapists bristle. The vast majority of psychotherapists
did not choose their careers to help clients become “better adjusted.” Such
terms raise the specter of the novel 1984 with its nightmares of coerced drug
treatment and mandatory conditioning (Orwell, 1964). Most psychologists
joined the profession to help their clients be more free, to learn to think for
themselves, and to make choices that align with their inner truth.
What Berger and Luckmann do offer, however, is a wider perspective
on the causes of client distress. Because Berger and Luckmann start from
the perspective of multiple cultures—all of which face the dilemma of how
to “sell” their view of reality to individual members—they offer the word
“deviants” to describe all the individuals who fail to integrate into a culture.
And they allow for a great deal of variability in terms of the causes of that
deviancy. Some individuals are not raised by functional parents. Others fail to
integrate because of poverty, racism, sexism, or trauma. Some become devi-
ants because the rewards of being “well-adjusted” are not sufficiently entic-
ing. From this point of view, for example, clients with anxiety disorders can
be seen as individuals who are not satisfied with the way the shared world-
view predicts the future; depressed people are individuals who don’t believe
the worldview offers a path to fulfill their hopes and dreams; and sociopaths
are individuals who failed to buy into the cultural worldview’s concepts about
justice and the rewards of delayed gratification.
Berger and Luckmann argue that every culture fails to fully integrate a
certain percentage of its candidates. Imagine that the most successful cultures
integrate 97 percent of their candidates and less successful cultures only inte-
grate 85 percent. Is this 12 percent difference due to a relative imbalance in
neurotransmitters in the low functioning culture? Is the prevalence of “mental
health disorders” 12 percent higher in any given culture? When examined
from a cross-cultural perspective, such explanations quickly break down.
Berger and Luckmann are arguing that the simple act of trying to integrate
into any given culture will result in some failures. Moreover, the failures are
not necessarily best conceptualized as psychopathology or deficits in brain
chemistry.
The concept of “deviancy” results in another interesting implication. Since
cultural constructions are supported by all members of the culture endorsing
the same basic worldview, deviants are considered the biggest threats to the
acceptance of that worldview. And, as has been argued above from a variety
of points of view, the disintegration of the prevailing cultural worldview
results in anxiety, depression, lack of motivation, and antisocial behaviors. In
this sense, deviants are always considered primary threats to cultural stability.
If they cannot be reeducated and reintegrated, they need to be marginalized,
minimized, and expelled. If they continue to try and make their presence felt
80 Chapter 3

and their views heard, they need to be incarcerated or even killed. The home-
less, the impoverished, and the mentally ill can be tolerated up to a point,
but if they become too prominent, a community will take action to minimize
their impact. Lower class suffering—those who live on the “wrong side of
the tracks”—is also tolerated as long as the deviants stay in their own place.
Since, by definition, conformity supports more conformity and deviancy
spawns more deviancy, all those who work with deviants are at risk in terms
of losing confidence in the solidity of their own worldview. There are a num-
ber of theories of therapist burnout ranging from compassion fatigue to lack
of personal power to working too hard or too long to mental health problems
in the provider. All of these theories underestimate or ignore the raw impact
of seeing one deviant after another—day in and day out—on the solidity and
stability of one’s worldview.
The most common response to this over exposure to deviancy is to develop
a theory that minimizes the credibility of the deviant attack. If the deviant is
an equal-status human being, her implicit attack on my worldview is likely
to have a strong effect on me. If somehow I can make her into a subhuman
being, then her deviancy is much less threatening. Obviously the simplest
way to make her subhuman is to define her as sick: I have normal neurotrans-
mitters; she has sick neurotransmitters. I have normal abilities to form human
attachments; she is so damaged that she is incapable of forming human
attachments. Ronald Siegel, a Buddhist therapist, comments:

Related to this point is the near universal tendency, in our quest to be helpful
or feel competent, to develop facile, simplistic, or reductionistic understandings
of our patients’ difficulties. “It’s a reaction to childhood sexual abuse,” “It’s
because of his narcissistic father,” “She’s a borderline,” and countless other con-
clusions help us to feel more secure as therapists while overlooking our patients’
complexity. (Siegel, 2012, p. 141)

Surrey and Jordan, also Buddhist therapists, comment in a similar vein.

When therapists feel uncertain or inadequate in therapy sessions, we sometimes

find ourselves turning to theory or distancing ourselves with diagnostic labels.
This grasping after fact and reason can take us away from our client and increase
the sense of aloneness for both. (Surrey & Jordan, 2012, p. 170)

While such conceptualizations do protect the worldview of the psychothera-

pists, they also have a number of negative outcomes. Obviously they mini-
mize the rapport between therapist and client; it is hard for a client to feel
close to a therapist who covertly needs to see the client as “sick” to avoid
being infected by his deviancy. Moreover, theories of client “illness” always
act as filters to the information available to the therapist. Once a person
 Social Constructionism 81

is seen as ill, the illness frame filters all incoming information in terms of
diagnoses and cures; we lose the ability to see the person as whole, complex,
multifaceted, and equal to ourselves.
The obvious solution to this dilemma of the encounter with the deviant is to
have therapists who have already come to peace with the constructed nature
of their own identity and culture and who, therefore, are not threatened by
deviants and their implicit challenge to the prevailing worldview. Such thera-
pists do not need to see deviancy as “sick” to avoid their own anxiety; rather,
relative to standard therapists, they can hear messages from deviant clients
with less filtering and less discounting.
Returning to the Berger and Luckmann quote and its argument that therapists
are social control agents, in many cases helping a client integrate into the cul-
ture is often a meaningful goal and sometimes the primary goal. In most cases,
an individual must first belong to the culture in order to achieve higher order
goals like individuation, positive relationships, or spiritual development. Urg-
ing clients to find a way to integrate into the culture is not a default violation of
personal rights; it is usually the only available road to becoming fully human.
However, cultural integration—“joining up”—or, indeed, any other therapeutic
goal is more easily achieved if the therapist is confident in her own worldview
and unconcerned that she might be polluted by the client’s deviancy. And,
finally, the requirement to join up can be politically complex if the culture only
offers the “deviant” client a subservient, oppressive, or limited role.
In sum, a closer examination of psychology quickly reveals its constructed
nature. The most obvious examples are diagnostic categories which rise and
fall at the whims of a committee. The inability of Western psychology to
move across cultural boundaries adds to the argument that it is constructed.
Moreover, the process of co-creating a pathological frame in order to resolve
the dilemma with a healing frame is clearly rooted in constructed reality.
Finally, Berger and Luckmann’s points about deviancy and social control
imply that at least a portion of psychotherapy is oriented toward helping cli-
ents accept a culturally constructed worldview.

FUNDAMENTAL REALITY VERSUS

CONSTRUCTED REALITY

The world has not gone one step beyond idolatry yet.
—Swami Vivekananda, The Complete Works
of Swami Vivekananda (1907)

The constructionist idea that “it’s all made up”—that it is constructed rather
than discovered—is absolutely offensive to many members of western
82 Chapter 3

culture. Even bright teenagers can summon simple arguments that support
the concept that there is an objective reality that is shared and must be recog-
nized. The concept that there is a concrete reality that actually exists is, not
surprisingly, called realism. And constructionism is forced to accommodate
to the arguments of realism in a variety of ways.
Certain constructionists endorse relatively radical beliefs and point out
that reality is always constructed and no two individuals can ever share real-
ity perfectly. They have many arguments supporting this concept; one of the
most simple and easy to understand is derived from the phrase “the map is
not the territory.” Coined by the famous general semanticist, Alfred Korzyb-
ski, the phrase means that regardless of the objective reality of the outside
world, it cannot be encountered directly. Rather, the “real world” outside is
represented internally as a “map.” This map varies from person to person
depending on their conditioning, experience, and culture; in that sense, there
is no fully shared reality, only our individual perspectives on it. And, my
belief that my map is accurate, and yours is not, leads to confusion, poor
communication, and conflict.
Regardless of whether such models make philosophic sense, there is a com-
mon sense divide between constructed reality and fundamental reality. This
book has used the pragmatic definition where fundamental reality equals the
material world—for example, trees and houses—and constructed reality refers
to our individual and cultural interpretations of the world, the other, and our-
selves. While this simple definition can be critiqued from a number of angles, it
provides a useful set of categories and can easily be applied to psychotherapy.
This moves us directly to the primary question: how much of the psycho-
logical world is constructed and how much is based on fundamental reality?
As one might expect, the constructionists argue that much more is con-
structed than is commonly believed and the realists counter with the idea that
the more we discover, the more we will understand that the universe really is
a complicated machine and we really can rationally decipher the intricacies
of the machine.1
At present, in psychology, this realist argument is probably best repre-
sented by the ongoing discoveries in neuroscience and genetics. It often
feels as if those advances are so interesting, compelling, and consequential
that they are poised to unlock the essence of human psychology. Following
that course, David Eagleman, a neuroscientist, recently wrote a book called
Incognito (2012) where he argues that human beings have much less con-
scious control over their life and decisions than is normally assumed. In the
book, he offers a variety of examples which show how little conscious con-
trol the individual actually has over his feelings, cognitions, and behaviors.
Among other topics, Eagleman reviews split brain research, effects of differ-
ent kinds of brain damage, and a variety of unconscious predictors of choices
 Social Constructionism 83

and decision-making. The following case involving a brain tumor is typical

of the material presented in his book.
A middle-aged man, Alex, came to the attention of his wife, Julia, when he
began to develop a strong interest in child pornography.

And not just a little interest, an overwhelming one. He poured his time and
energy into visiting child pornography websites and collecting magazines. He
also solicited prostitution from a young woman at a massage parlor, something
he had never previously done. This was no longer the man Julia had married,
and she was alarmed by the change in his behavior. At the same time, Alex was
complaining of worsening headaches. And so Julia took him to the family doc-
tor, who referred them on to a neurologist. Alex underwent a brain scan, which
revealed a massive brain tumor in his orbitofrontal cortex. The neurosurgeons
removed the tumor. Alex’s sexual appetite returned to normal.
. . . The lesson of Alex’s story is reinforced by its unexpected follow-up.
About six months after the brain surgery, his pedophilic behavior began to
return. His wife took him back to the doctors. The neuroradiologist discovered
that a portion of the tumor had been missed in the surgery and was regrowing—
and Alex went back under the knife. After the removal of the remaining tumor,
his behavior returned to normal. (pp. 154–155)

Eagleman argues that this type of evidence and the other examples in his
book demonstrate that people have far less control over themselves than they
imagine. In fact, he even goes so far as to argue that there is no actual free
will; instead all choices, behaviors and the sense of self are simply biology.

The crux of the question is whether all of your actions are fundamentally on
autopilot or whether there is some little bit that is “free” to choose, independent
of the rules of biology. This has always been the sticking point for both phi-
losophers and scientists. As far as we can tell, all activity in the brain is driven
by other activity in the brain, in a vastly complex, interconnected network. For
better or worse, this seems to leave no room for anything other than neural activ-
ity—that is, no room for a ghost in the machine. To consider this from the other
direction, if free will is to have any effect on the actions of the body, it needs
to influence the ongoing brain activity. And to do that, it needs to be physically
connected to at least some of the neurons. But we don’t find any spot in the brain
that is not itself driven by other parts of the network. Instead, every part of the
brain is densely interconnected with—and driven by—other brain parts. And
that suggest that no part is independent and therefore “free.” (p. 166)

Eagleman presses the point even further and postulates that every example
of criminal behavior or abnormal functioning is fundamentally due to brain
damage or cognitive dysfunction. We may not currently possess the technol-
ogy to diagnose, predict, and understand the nature of this dysfunction, but
84 Chapter 3

this technology is on the way. And the implications of his arguments and
examples are that brain damage is concrete, real, difficult to modify, and most
responsive to surgical and medical interventions.

As the neuroscientist Wolf Singer recently suggested: even when we cannot

measure what is wrong with the criminal’s brain, we can fairly safely assume
that something is wrong. His actions are sufficient evidence of a brain abnor-
mality, even if we don’t know (and maybe we’ll never know) the details. As
Singer put it: “As long as we can’t identify all the causes, which we cannot and
will probably never be able to do, we should grant that for everybody there is a
neurobiological reason for being abnormal.”
. . . The bottom line of the argument is that criminals should always be treated
as incapable of having acted otherwise. The criminal activity itself should be
taken as evidence of brain abnormality, regardless whether currently measurable
problems can be pinpointed. (p. 177)

This argument, of course, suggests that all significant dysfunction, whether

it violates the legal code or not, is nonvolitional; in that sense, we should be
compassionate toward the misbehaving person because, in truth, they lacked
the ability to operate in an ethical manner.
There are several obvious problems with Eagleman’s arguments. First,
the concept that all criminal behavior is the result of an abnormal brain sug-
gests that we have a clear definition of criminal behavior. Since such defini-
tions are socially constructed, this argument runs into trouble from the very
beginning. For example, if having an abortion is criminal behavior, does a
change in the law mean that we have cured a brain abnormality? Similarly,
most all of us would agree that murder is one of our most criminal acts;
if anything should define the abnormal brain, it should be murder. Now,
certainly we do not consider soldiers to be murderers. Yet in guerilla war-
type conflicts many soldiers report killing innocent civilians either through
misconstruals, in the fog of war, or in the heat of battle. Do all these sol-
diers possess abnormal brains? Do the brains become “abnormal” after the
murder occurs?
Examine Eagleman’s arguments from the standpoint of criminal behavior
across race.

One in every three black males born today can expect to go to prison at some
point in their life, compared with one in every six Latino males, and one in every
17 white males, if current incarceration trends continue.
These are among the many pieces of evidence cited by the Sentencing Proj-
ect, a Washington, D.C.-based group that advocates for prison reform, in a
report on the staggering racial disparities that permeate the American criminal
justice system. (Knafo, 2013)
 Social Constructionism 85

Using Eagleman’s arguments, these statistics prove that there are severe brain
abnormalities in black males, moderate abnormalities in Latino males, and
milder rates of abnormalities in Caucasians. I doubt that Eagleman intended
to argue that blacks have more brain damage, yet that finding jumps out of
the data.
Contradictions such as the above often occur when fundamental real-
ity and constructed reality are confused. Eagleman is a neuroscientist; he
believes his work is based in fundamental reality. His primary error is not
racism; rather, it is assuming that categories like “criminal behavior” or
“mental health” are fundamental reality categories, when, in fact, they are
constructed categories. In Eagleman’s defense, psychology presents its cat-
egories and diagnostic manuals as if they are based in fundamental reality.
Unfortunately, given that they are constructed, errors similar to Eagleman’s
occur frequently.
The “lack of free will due to all neurons being interconnected” argument
is also shaky. Eagleman would need to prove that every psychic event ever
experienced were all exaggerations and lies. Jack Kornfield (1993, p. 52)
describes an experience that occurred in a Hospice program. Apparently the
children of a dying sixty-five-year-old were sitting outside his room during
a visit when they received the information that their father’s brother had just
been killed in a car accident. They debated whether to tell him, worrying that
it might upset him. When they went in to see him, he said:

“Don’t you have something to tell me?” . . . “Why didn’t you tell me that my
brother died?” Astonished, they asked how he had found out. “I’ve been talking
with him for the past half hour.”

He offered some parting words to each child and died within the hour. And
here is another such story from a different angle.

Another young American man, who knew nothing of spiritual life, had a dream
of a Tibetan lama while sick in the hospital. Two years later, while traveling in
Nepal, he met the very lama who appeared in his dream. This lama smiled and
said, “I have been expecting you.” (Kornfield, 1993, p. 233)

Such stories are relatively common. Even if many of them can be

debunked, is it likely that every one of them is a fantasy? Moreover, every
psychic who ever helped a police department find a clue to a crime would
need to be discredited. All of these examples embody experiences where indi-
viduals have access to information that could not have come from intercon-
nected neurons. Even one valid example of this kind of experience destroys
Eagleman’s arguments.
86 Chapter 3

Finally, we come to the concept that Eagleman’s arguments strongly sup-

port the worldview that the Universe is an intricate machine and that science
will eventually discover the machine’s secrets. This chapter has already
shown the difference between this kind of “faith-based” science and the
basic scientific method which functions to make human life easier and more
productive.
All of those points being made, Eagleman’s arguments—and the argu-
ments of other realists—certainly suggest that there is something “out there”
that limits constructionism’s ability to create new realities out of thin air.
Could even the most gifted therapist create a sufficiently powerful interven-
tion with Alex that would result in a decrease in his pedophilia? Most of us
would answer that question in the negative; the pathological effects of the
brain tumor were so significant that they were likely to negate the power of
even the most brilliant therapist. Reality would trump constructionism.
And, obviously, there are many other examples similar to that of Alex and
his brain tumor. Eagleman is arguing against the effect size of construction-
ism and all psychological interventions in favor of the power of the structural
and biochemical realities of the brain. In this sense he is united with the bio-
psychiatrists who, at their most extreme, believe that medications are vastly
more effective than psychotherapy when it comes to altering dysfunctional
human behavior. Finally examine the following quote from a psychiatrist
who works on a daily basis with the mentally ill. While he is sympathetic to
constructionism, he points out its limitations.

However, this vein of research has been tarred by its own crude ideology. If
scientism can falsely turn ethical and political issues into matters of disease, and
grossly exaggerate what we know about the nature of mental illness, Foucault
and his acolytes are prone to an antithetical failing: radical social construction-
ism. Madness, they would have us believe, whether it is schizophrenia, post-
traumatic stress disorder or anorexia, is not grounded in any biological reality.
Greedy commercial interests and a repressive society, they claim, have falsely
transformed human differences and personal choices into psychiatric disorders.
Arguments of this sort can be morally compelling, for they appeal to the
liberal ideal of toleration and argue for the civil rights of stigmatized minori-
ties. However, no one is a Foucauldian in an emergency room. I was a medical
resident in psychiatry when I first studied Foucault’s arguments, and I got the
distinct impression that his “madness” was often just a metaphor with which to
challenge authority, not much related to the shaking, hallucinating teenager that
I would soon return to on the wards.
To me, Foucault and his followers seemed impossibly naïve, even com-
placent. Had they ever encountered severe obsessive-compulsive disorder or
suicidal depression? Had they ever seen a manic patient take lithium and be
restored? Psychiatrists might be blinded by their commitments as insiders, but
 Social Constructionism 87

this academic view seemed sustainable only by remaining on the outside look-
ing in. (Makari, 2016)

Makari appeals to common sense. constructionism is well and good but in

the trenches of psychiatric care, arguing that “it’s all made up” disrespects
the way in which mental illness plays out in daily life; more specifically, he
argues that the gravity of certain mental health symptoms overpower con-
structionist arguments.
While there is a certain attraction to the argument that florid symptoms
indicate that the individual’s problems must be rooted in fundamental reality,
it is easy to offer many examples of florid symptoms occurring in constructed
reality. For example, inexperienced sailors on a small sailboat might encoun-
ter gale conditions when making a blue water passage. Convinced they are
about to die, the beginners might cry, scream, and throw themselves to the
deck. Moreover, they could become disoriented, enter a fugue state, or uri-
nate on themselves. Conversely, the captain, who is aware that weathering
the gale is well within the capacity of the sailboat, shows no symptoms of
anxiety or decompensation. Constructed reality is emotionally equivalent to
fundamental reality for most members of the culture and the “shaking, hal-
lucinating teen” might be living in his own version of hell. The presence of
florid symptoms does not prove that the causes of the distress must be rooted
in fundamental reality.
In fact, it is easy to argue that most of our symptoms of psychological
distress are derived from constructed reality. The goals of life—happiness,
contentment, achieving social respect, living the good life—are all con-
structed and vary from culture to culture. Depression, anxiety and many other
psychological conditions arise as the individual compares their social status
and success against their expectations. Advocates against racism, sexism,
and classism argue that the biopsychiatric tendency to see all psychological
symptoms in terms of bad genetics and biochemistry stigmatizes individuals
in liminal groups; furthermore, they believe such theories indicate both poor
thinking and bad science.
It is relatively easy to propose a simple theory that includes the contribu-
tions of both fundamental reality and constructed reality. Imagine life is like
a foot race. First, one must have the capacity to run in the race. Getting to
the starting line with that capacity is a question for fundamental interven-
tions. Alex’s brain tumor would have precluded running the race. Therefore
he needed an intervention in fundamental reality—surgery—to get to the
starting line. However, the race itself is run in constructed reality. Managing
expectations, dealing with social forces, cultivating hopefulness and motiva-
tion, reducing cognitive misconstruals—all of these factors primarily operate
in constructed reality.
88 Chapter 3

Is the race analogy perfect? Of course not; there are constructed reality
factors that are relevant in terms of getting to the starting line and funda-
mental factors that influence the running of the race. However, the primary
analogy—that functionality in fundamental reality is necessary but not suf-
ficient—holds true. Another way to look at this is through reviewing the
simplistic hope that “eventually drug therapies will become so effective
that they will eliminate mental health problems.” This expectation, which is
clearly rooted in the “faith-based” aspect of science—ignores the fact that a
functional body and brain do not guarantee immunity to depression, anxiety,
and trauma nor do they guarantee happiness and contentment in life. In sum,
some form of psychotherapy—or an equivalent technology that focuses on
constructed reality—will always be incorporated into human culture regard-
less of scientific and medical advances. Biopsychiatrists who belittle the
value of psychotherapy are simply confused.
That said, constructionism often states its case as if there are no limits on
its power to reshape reality. In truth, fundamental reality places actual limits
on the ability to change and grow. The arguments proposed by Eagleman,
Makari, and other realists are supported by common sense. It seems clear that
there are effect sizes from brain injuries, congenital problems, environmental
toxins, and all manner of interactions between the human and his physical,
genetic, and biochemical environment.
Just as obviously, there are effect sizes due to constructing reality. Deter-
mining the exact relationship between these two forces would take an entire
book in itself and, again, that is not the purpose of this book. Until that issue
is worked out, it should simply be stipulated that Reality exists and that it will
sometimes function to limit the constructionist’s attempt to create new social
and meaning-based “truths.”
However, in general, those reality-based limits are much smaller and less
important than Eagleman and his colleagues would have you think. Remem-
ber that System 1 tends to see all reality as fundamental reality. This suggests
that the current line dividing fundamental reality from constructed reality will
always be skewed toward overestimating the percentage of experiences that
are determined by fundamental reality. As a closing metaphor, review the
following example from Frank Farrelly. In this vignette, Farrelly discusses an
intervention with a schizophrenic. Since schizophrenia is widely considered
to be a highly biologically based disorder, it is an ideal diagnosis to demon-
strate the effectiveness of a socially constructed intervention.

A female catatonic patient who had been completely mute for six months was a
problem to the ward staff. I was convinced that she was putting on a big act, that
she had even extinguished her startle response, and that though she gave no sign
that she was aware of anyone around her, she could be made to talk relatively
 Social Constructionism 89

easily. I made a bet of two dollars with some of the staff . . . that I could provoke
a clearly articulated English sentence from her along with appropriate congruent
affect––an integrated response—within one week’s time.
My reasoning was twofold: 1) she was treating us like pieces of furniture and
not even acknowledging our existence as persons, and thus I (along with several
other staff members, chosen carefully for their weight) would treat her as a piece
of furniture and sit on her for 10 three-minute “lap sitting trials” per day for a
week. 2) I reasoned that even though she was obviously “mentally diseased,”
nonetheless as I said to the staff, “the thigh bone is connected to the backbone,
which is connected to the head bone, which is connected to the tongue bone,
and she’s gonna talk when her thighs feel squashed enough.” My bet was, the
conflicts in her thighs would outweigh those in her head.
The “lap sitting trials” were begun and were immediately sequential. On the
fourth trial she pushed hard, but that nonverbal response, even though it dem-
onstrated clearly that she was returning from her limbo, did not count. On the
sixth trial she burst out laughing, pushed hard on the staff member’s back, and
clearly enunciated, “get the hell off my lap.” So much for mute catatonia: if six
months of it can be counter conditioned after only 18 minutes of innocuous lap
sitting, it obviously cannot be that serious a condition. (Farrelly & Brandsma,
1981, pp. 121–122)

BIOPSYCHIATRY AND THE MEDICAL MODEL

A thing is not necessarily true because a man dies for it.

—Oscar Wilde, The Portrait of Mr. W. H. (1889)

If the faith-based assumptions of science are constructed and psychology is

constructed, then what of biopsychiatry? Is it an example of realism or is it as
constructed as psychotherapy?
The proliferation of psychiatric diagnoses has already been discussed in
a previous section. However, there is a particularly interesting history to the
evolution of the DSM that is relevant here. In the 1970s, psychiatry was in cri-
sis. Most psychiatrists had functioned as Freudian analysts, providing therapy
to neurotic patients. However, the burgeoning fields of psychology and social
work were also supplying therapists who were in direct competition with the
psychiatrists. Besides, the rest of the medical field looked down their noses at
psychiatrists, claiming that they were unscientific and weren’t “real” doctors.
Finally certain medications, such as early antidepressants and antipsychotics,
had had a major impact on the field and their advocates were promoting them
as the future of psychiatry and mental health treatment. As a result of these
factors, certain leaders in psychiatry decided to shift the focus of the profes-
sion from unconscious childhood conflicts to brain science.
90 Chapter 3

Psychiatrists began to refer to themselves as psychopharmacologists, and they

had less and less interest in exploring the life stories of their patients. Their main
concern was to eliminate or reduce symptoms by treating sufferers with drugs
that would alter brain function. (Angell, 2011b, p. 2)

They adopted a conscious strategy to move psychiatry back into the main-
stream of medicine. The medical director of the American Psychiatric Asso-
ciation (APA), Melvin Sabshin, declared in 1977 that “a vigorous effort to
remedicalize psychiatry should be strongly supported, and he launched an all-
out media and public relations campaign to do exactly that” (Angell, 2011b,
p. 2). The primary vehicle for this remedicalization was the upcoming DSM
III release. The first two DSM’s were psychodynamic and little known outside
the profession. But this new version was going to be different. Robert Spitzer,
a leading psychiatrist, fully intended to use the DSM III to rebrand psychiatry.

Spitzer set out to make the DSM-III something quite different. He promised that
it would be “a defense of the medical model as applied to psychiatric problems,”
and the president of the APA in 1977, Jack Weinberg, said it would “clarify to
anyone who may be in doubt that we regard psychiatry as a specialty of medi-
cine.” (Angell, 2011b, p. 2)

In addition to legitimizing psychiatry, the DSM had a second goal: providing

a justification for psychotropic medications. Essentially, Spitzer and his com-
mittee members created diagnostic categories that were not only arbitrary but
specifically oriented toward the psychotropic medicines that were in current
favor. For example, following is a first person account of the creations of
“Panic Disorder” and “Generalized Anxiety Disorder.”

David Sheehan worked on the DSM-III task force. One night in the mid-1970s
Sheehan recalls, a subset of the task force got together for dinner in Manhattan.
“As the wine flowed,” Sheehan says, the committee members talked about how
Donald Klein’s research showed that imipramine blocked anxiety attacks. This
did seem to be pharmacological evidence of a panic disorder that was distinct
from other kinds. As Sheehan puts it:
Panic disorder was born. And then the wine flowed some more, and the psy-
chiatrists around the dinner table started talking about one of their colleagues
who didn’t suffer from panic attacks but who worried all the time. How would
we classify him? He’s just sort of generally anxious. Hey, how about “general-
ized anxiety disorder”? And then they toasted the christening of the disease with
the next bottle of wine. And then for the next thirty years the world collected
data on it. (Stossel, 2014, p. 191)

As the last sentence implies, neuroscientists, who take the DSM seriously (as
they must since they are hardly experts in nosology), would be looking for
 Social Constructionism 91

structures and processes in the brain common to generalized anxiety disorder

(GAD) patients. This arbitrary shift in the DSM results in a big shift in the
direction of the neuropsychological research. And, of course, since seekers
often find what they seek, this contribution may, in fact, have created (con-
structed) neurobiological advances.
The problem, of course, is that DSM III looked like a serious diagnostic
manual but since it had been essentially cobbled together by the commit-
tee—without being based on research or scientific findings—the diagnoses
were arbitrary and overlapping. One therapist would diagnose a client as
depressed, the next one would say he had an anxiety disorder, and the third
might believe it was a personality disorder. In sum, the manual did not gener-
ate reliable diagnoses and, although the subsequent editions of the DSM have
endeavored to improve the situation, the present DSM suffers from equally
significant problems with reliability.
More importantly, however, the arbitrary manner with which the diagnoses
were created argued that they had little validity; that is, they did not reflect
any underlying or fundamental conditions that caused or contributed to the
mental health disorder. Standard medicine is proud that their diagnosis of, for
example, diabetes, is supported by confirmatory blood tests. In psychiatry,
however, in spite of over a half century of looking, not one diagnosis has been
linked to an underlying biological condition. There are no scans or blood tests
for anxiety, depression, or schizophrenia.

What these pages do not say is that despite 50 years of Herculean efforts, the
invention of electron microscopy, the advent of radiolabeling techniques, the
revolution of molecular biology, and the merger of computers with neuroimag-
ing machines, no reliable biological marker has ever emerged as the definitive
cause of any psychiatric “disease.” What many fail to appreciate is that bio-
chemical imbalances and other so-called functional mind diseases remain the
only territory in medicine where diagnoses are permitted without a single con-
firmatory test of underlying pathology. (Sparks, Duncan, & Miller, 2006, p. 91)

The medical model upon which psychiatry is based requires a reliable and
valid diagnosis (confirmed by objective tests) which then leads to a treatment
which results in amelioration of symptoms or a cure of the condition. We
have already seen the problems with diagnosis, what about the efficacy of the
psychotropic drugs that form the basis of treatment?
Approximately 11 percent of Americans take an antidepressant—that
amounts to over 30 million people. The outcome research documents results
that are virtually identical to the psychotherapy research: 75 percent of these
people report modest, positive improvement in their symptoms. (Sparks, Dun-
can & Miller, 2008) The problem, unfortunately, is that recent research reviews
have shown that virtually all of that improvement is due to placebo effect.
92 Chapter 3

But ever since a seminal study in 1998, whose findings were reinforced by land-
mark research in The Journal of the American Medical Association last month,
that evidence has come with a big asterisk. Yes, the drugs are effective, in that
they lift depression in most patients. But that benefit is hardly more than what
patients get when they, unknowingly and as part of a study, take a dummy pill—
a placebo. As more and more scientists who study depression and the drugs that
treat it are concluding, that suggests that antidepressants are basically expensive
Tic Tacs. (Begley, 2010, p. 1)

Moreover, if we have actually identified and treated the 11 percent of the

population that is actually depressed, one would expect to get a decrease in
depression nationwide. Instead we have the following findings.

Looking at recent scientific studies, Moncrieff (2001) concluded that despite

their increasing use, antidepressants give no indications that they have lessened
the burden of depressive experiences. Her observation was partially fueled by an
inspection of prevalence rates over a 40-year-period. That analysis showed that
rates of depression had not changed since the 1950s. The most recent National
Comorbidity Study Replication (Kessler et al. 2005) confirms Moncrieff’s
assessment that rising antidepressant rates have made hardly a dent in depres-
sion prevalence. Antidepressants, Moncrieff reasoned, are overrated. Others
have come to the same conclusion, citing that the difference in outcome between
antidepressants and placebos is much smaller than the public has generally been
led to believe. (Sparks, Duncan, & Miller, 2006, p. 92)

Why has the ineffectiveness of antidepressants only recently come to light? It

appears that the research literature supporting antidepressants was tampered
with through various means. First and foremost, the drug companies have a
huge, vested interest in the success of antidepressants. Not surprisingly, they
have been guilty of hiding studies that showed antidepressants were no better
than placebos, of hiring psychiatrists to serve as their spokesmen at major
conferences, and of conducting studies without adequate research design
(Sparks, Duncan, & Miller, 2008). Moreover, even the well conducted studies
were primarily done with passive versus active placebos. Since antidepres-
sants have side effects, the research subjects could tell whether they were
getting the “real” medication or the sugar pill. When antidepressants are
compared to other medications that have side effects—active placebos such
as atrophine (which causes dryness of the mouth)—there are almost no stud-
ies that showed a clinically significant benefit for antidepressants.
And what of the oft-touted model of “chemical imbalance”: the well-
publicized theory that depression is due to a serotonin deficit at the synapses
of the brain and that this condition is remediated by antidepressants? It turns
out that this seemingly solid theory—which is usually advanced as “scientific
fact”—simply fails to stand up.
 Social Constructionism 93

In the first place, the theory originated as a speculative jump from some
suggestive research findings.

Unfortunately, the serotonin-deficit theory of depression is built on a foundation

of tissue paper. How that came to be is a story in itself, but the basics are that
in the 1950s scientists discovered, serendipitously, that a drug called iproniazid
seemed to help some people with depression. Iproniazid increases brain levels
of serotonin and norepinephrine. Ergo, low levels of those neurotransmitters
must cause depression. (Begley, 2010, p. 5)

This was certainly an interesting finding, and deserved to be followed up,

but it was hardly proof that a deficit in serotonin or norepinephrine at the
synapses caused depression. That theory particularly falls apart when one
examines subsequent research. For example:

Direct evidence doesn’t exist. Lowering people’s serotonin levels does not
change their mood. And a new drug, tianeptine, which is sold in France and
some other countries (but not the U.S.), turns out to be as effective as Prozac-
like antidepressants that keep the synapses well supplied with serotonin. The
mechanism of the new drug? It lowers brain levels of serotonin. “If depres-
sion can be equally affected by drugs that increase serotonin and by drugs that
decrease it,” says Kirsch, “it’s hard to imagine how the benefits can be due to
their chemical activity.” (Begley, 2010, p. 5)

And this finding was not limited to tianeptine; it was easy to replicate it across
a variety of drugs including opiates and amphetamines.

Kirsch was also struck by another unexpected finding. In his earlier study and
in work by others, he observed that even treatments that were not considered
to be antidepressants—such as synthetic thyroid hormone, opiates, sedatives,
stimulants, and some herbal remedies—were as effective as antidepressants in
alleviating the symptoms of depression. Kirsch writes, “When administered as
antidepressants, drugs that increase, decrease or have no effect on serotonin all
relieve depression to about the same degree.” What all these “effective” drugs
had in common was that they produced side effects, which participating patients
had been told they might experience. (Angell, 2011b, p. 7)

And, finally, the biggest problem with the theory is that, as far as it can
be measured, neurotransmitter function seems to be normal in people with
depression; moreover, many people with low levels of neurotransmitters
show no signs of depression.

But the main problem with the theory is that after decades of trying to prove
it, researchers have still come up empty-handed. All three authors document
94 Chapter 3

the failure of scientists to find good evidence in its favor. Neurotransmitter

function seems to be normal in people with mental illness before treatment. In
Whitaker’s words:
Prior to treatment, patients diagnosed with schizophrenia, depression, and other
psychiatric disorders do not suffer from any known “chemical imbalance.”
However, once a person is put on a psychiatric medication, which, in one man-
ner or another, throws a wrench into the usual mechanics of a neuronal pathway,
his or her brain begins to function . . . abnormally. (Angell, 2011b, p. 5)

There is compelling evidence that disproves the “chemical imbalance” theory

and equally compelling evidence that documents that antidepressants are no
better than active placebos. Given these facts, how did psychiatry and the
public become so convinced that the truth is otherwise? The simple answer
is: money and the influence it can buy.
Most thoughtful citizens are aware that legislators at both the federal and
state level are significantly influenced by money and power. It is not as well
known that pharmaceutical companies have similarly used their financial
assets to corrupt the “science” around the biological basis of mental illness
and the efficacy of the psychotropic drugs used to treat them. Given the
payoffs from the pharmaceutical companies, it is hard to see how they could
have resisted. Not only are 11 percent of all Americans on antidepressants
but “[t]he new generation of antipsychotics, such as Risperdal, Zyprexa, and
Seroquel, has replaced cholesterol-lowering agents as the top-selling class of
drugs in the US” (Angell, 2011a, p. 2). In short, the market for psychotropic
drugs is worth billions and billions of dollars. If you were a pharmaceutical
company executive, wouldn’t you spend money to ensure that there is “sci-
entific support” for your product?
And spend money they have. First they went after the research. It was
documented above that double blind studies conducted by pharmaceutical
companies were a third more likely to find significance than studies done by
independent researchers. The companies also hid many studies that found
no difference between their new products and standard drugs and placebos.
More insidiously, however, they made a concerted effort to determine who
were the most prominent members of the psychiatric community and took
effective steps to get these people on their payroll. Angell (2011) documents
an extensive campaign by big pharma to influence the field via the following
steps: 1) hiring key opinion leaders as consultants, 2) making donations to
patient advocacy groups, educational organizations, and professional orga-
nizations, and 3) influencing university and medical school departments.
For example, review the analysis below of the pharmaceutic industry’s influ-
ence at the university.
 Social Constructionism 95

Finally, to claim, as Preston does, that university research is “clean” reflects a

lack of understanding about how industry money gets spent. The majority of
drug company trials are conducted by university research institutions. Industry
money constitutes a significant portion of the dollars that flow into academic
research, supporting researchers and general operations.
Antonuccio et al. (2003) detail the vast reach of the pharmaceutical indus-
try—from Internet, print, and broadcast media, direct-to-consumer advertising,
“grassroots” consumer-advocacy organizations, and professional guilds to med-
ical schools, prescribing physicians, and research—even into the boardrooms of
FDA. They conclude, “It is difficult to think of any arena involving information
about medications that does not have significant industry financial or marketing
influences.” (Sparks, Duncan, & Miller, 2006, pp. 97–99)

Up to this point, we have concentrated on the efficacy of antidepressants. What

of other classes of psychotropic drugs? Sparks, Duncan, and Miller (2006)
present some rather disturbing information about the interaction between
psychotropic drugs and the course of treatment in schizophrenia. Citing stud-
ies that compare first world treatments’ outcomes for schizophrenia—where
the treatment virtually always includes antipsychotic medication—with third
world treatments—which rarely include antipsychotics—they note that the
outcomes are much better in the third world paradigm. Patients who either
never took medication or who weaned themselves off medication had shorter
courses of psychosis, spent less time in hospitals, and were more likely to be
employed and have adequate social networks.
This research raises the alarming possibility that the medications used in
the treatment for schizophrenia are actually having a negative effect. Psy-
chiatrists who are concerned with this possibility cite a number of arguments.
First, historically conditions such as schizophrenia were once self-limiting
and episodic whereas now the conditions are chronic and lifelong. Second,
some psychiatrists speculate that the psychotropic drugs have long-term
effects on neural functioning probably as the result of the body attempting
to adjust to the effects of the medications through negative feedback—a
process where the brain essentially attempts to nullify the drug’s effects.
Third, the drugs have powerful side effects which, in turn, require treatment
by other powerful drugs creating an unpredictable set of drug interactions.
Many patients with serious mental health conditions are placed on five or six
drugs simultaneously. Finally there is some evidence that these kinds of drug
cocktails gradually lead to prefrontal cortex atrophy (Angell, 2011). Obvi-
ously, this would be an extremely alarming situation if these arguments are
sustained. At this point, however, these are simply speculations, albeit specu-
lations with enough grave implications that they ought to be taken seriously
by all mental health practitioners.
96 Chapter 3

The purpose of this section is not to perform a full review of all the infor-
mation about psychiatry and the medical model or the effectiveness of psy-
chotropic medication. Such a review would require listing all the rebuttals to
the findings above offered by the defenders of psychiatry and the pharmaceu-
tical industry. In addition, all the major diagnostic categories would require
review including ADHD and bipolar disorder. This type of endeavor would
require a full book in its own right and that is not the purpose of this text.
However, this brief review of biopsychiatry does demonstrate that there
is substantial evidence that the medical approach to mental health is as con-
structed as the psychological approach. The history of the evolution of the
DSM supports the constructed nature of diagnoses. The misrepresentation
of the research shows that the impartiality of the scientific method has been
breached. The scientific vow to approach all facts with a critical perspective
has been repeatedly flouted. And the effects of money and advertising on the
profession and the public show that the ability of the powerful to influence
science is as strong now as it was in the days of the medieval church and
Galileo.
For the constructionist, the most interesting aspect of biopsychiatry is not
the question, “do medications work?” Rather, the most relevant question is:
“how is biopsychiatry framed?” The primary implicit claim of biopsychiatry
is that medications treat the cause of psychiatric disorders. More specifically,
psychotropics treat mental illness like antibiotics treat an infection. The prob-
lem with this claim is that there is no accepted theory about the biological
basis of mental illness nor is there any objective test that can determine the
presence or absence of mental illness. Exceptions exist—such as the brain
tumor discussed in the last chapter—but mental illness is essentially diag-
nosed by interpreting deviant feelings and behaviors. And we are unclear
about whether the factors underlying deviancy are based in fundamental or
constructed reality.
Realists will argue that it is only a matter of time before more is discov-
ered about the biological basis of mental illness and that the more florid
diagnoses—for example, schizophrenia and bipolar—are the most likely to
be influenced by fundamental reality factors. This may be proven true over
time—no one has a crystal ball about such matters—but it is also true that
fully exploring constructed reality will reveal that more is constructed than
we currently believe. The important point is that, at present, we fail to have a
biological theory that explains mental illness and we have no objective mea-
surements that differentiate normal from deviant. In sum, without an accurate
theory about the biological basis of each diagnosis, we cannot claim that the
medications treat the cause of the mental illness.
The second implicit assumption—that psychotropic medications effec-
tively suppress mental health symptoms over long periods of time—also has
 Social Constructionism 97

problems. This claim is similar to the effectiveness of insulin with diabetes;

insulin doesn’t treat the cause of diabetes but it controls symptoms over
the life span. This claim is easier to support. Anxiolytics do control symp-
toms of anxiety; unfortunately their continued use results in tolerance and
withdrawal effects so they fail to ameliorate the anxiety over long periods.
Amphetamines are effective at enhancing focus and attention, not simply
with ADD clients but with humans in general. It is an open question whether
their effectiveness fades over time as the body attempts to regain homeosta-
sis. Major tranquilizers are effective at suppressing psychotic, bipolar, and
dementia symptoms; the issue with these drugs is that the suppression of
significant agitation and anxiety also suppresses the ability to think, feel, and
function. The cost benefit analysis of such suppression continues to provoke
meaningful discussion. In sum, biopsychiatry is effective at short term con-
trol of symptoms but has difficulty demonstrating that its drugs are helpful
over long periods of time; moreover, the side effects can be significantly
problematic.
A third way to look at the framing of psychotropic medications is a bit
more radical; moreover, it is unpopular both with the pharmaceutical com-
panies and with the psychiatric community. This perspective simply states
that a variety of drugs can create states that can be helpful in terms of deal-
ing with psychiatric symptoms. From this perspective, alcohol is probably
the most useful drug discovered by humans. At correct doses it effectively
treats social anxiety, is conducive to relaxation, and creates positive states of
disinhibition and euphoria. Opiates, for certain people, are terrific anxiolytics
and also create euphoria and a mild bump in energy. Hallucinogens are useful
for getting people out of a rut and have been effective at treating everything
from depression to PTSD to marital dysfunction. No one would want to work
in a psychiatric emergency room without access to major tranquilizers and
the helpfulness of amphetamines and benzodiazepines is already documented
above. Interestingly, one of the best ways to rank the usefulness of drugs is
to examine their price “on the street.” Opiates, alcohol, marijuana, hallucino-
gens, and amphetamines are worth quite a lot. Major tranquilizers are worth
a little and antidepressants have no street value.
While it is true that some psychiatrists pragmatically adopt this more radi-
cal view—and will use anything legal to create therapeutic change in their
patients—the field as a whole cannot accept such a model. A psychiatrist who
says something like “I decided to add Adderall to the antidepressant because
I wanted the patient to experience a boost in energy,” would likely get in
trouble because this pragmatic approach fails to honor the medical model of
the “medication fits the diagnosis.” Such an approach might help the patient
but it would open psychiatry to a kind of “theory-free,” Wild West kind of
environment where psychiatry would lose much of its scientific justification.
98 Chapter 3

There are equivalent problems with defining psychiatry as a field where

doctors primarily prescribe drugs that help suppress psychiatric symptoms
over the short term. While it can be argued that this model is more accurate
than the prevailing medical model, accepting the short term model would
diminish the respect for the field and the respect for the value of medica-
tion. Moreover, many of the placebo benefits of medications would be lost.
The willingness to tolerate side effects would go down; some patients would
refuse to take medications with significant side effects if they didn’t believe
that these medications were treating the cause of their mental illness. When
the statement: “you have clinical depression and will need to stay on anti-
depressants the rest of your life” is no longer seen as accurate, the value of
biopsychiatry will plummet.
In sum, biopsychiatry uses drugs that operate in fundamental reality and
create real responses in patients. The constructed aspect of psychiatry is the
concept that psychotropics treat the biological cause of mental illness and the
related concept that the medications successfully control symptoms over long
periods of time. In spite of these issues, psychiatry continues to be a highly
useful adjunct in mental health treatment; however, psychotherapeutic prac-
titioners need to deconstruct certain “scientific” assumptions and stay aware
of the actual effects of medications.
Most importantly, we need to cultivate discernment regarding the empiri-
cal view that the universe is a complicated machine and that mental health
problems can be solved once we dissemble the complex biomechanisms of
the human brain. The faith-based assumption that “one day we will have great
medications that will cure all mental illnesses,” will never come to fruition
given that so many of our illnesses are created and sustained by challenges,
problems, and injustices in constructed reality. Understanding the seductive
allure of faith-based science opens the door to a realistic assessment of the
positive and negative effects of psychopharmacology.

RELATIVISM, CHAOS, AND ANOMIA

Existential writers like Kurt Vonnegut (2010) make fun of the human need
for foundations and meaning.

“In the beginning, God created the earth, and he looked upon it in his cosmic
loneliness.”
And God said, “Let Us make living creatures out of mud, so the mud can see
what We have done.” And God created every living creature that now moveth,
and one was man. Mud as man alone could speak. God leaned close to mud as
man sat, looked around, and spoke. “What is the purpose of all this?” he asked
politely.
 Social Constructionism 99

“Everything must have a purpose?” asked God.

“Certainly,” said man.
“Then I leave it to you to think of one for all this,” said God.
And He went away. (p. 264)

That is the precise dilemma that one experiences following repeated expo-
sure to constructionists, cultural anthropologists, Buddhists, and postmodern
thinkers: the world has been deconstructed leaving no solid place to stand.
Reality has become Humpty-Dumpty and nothing can put it together again.
When constructionism and postmodernism are taken seriously, the world as
we know it no longer exists. Gergen relates a story of two students enrolled
in one of his seminars. They were so disturbed by constructionism—calling it
immoral and nihilistic—that they actually complained to the Provost.

“Without any truth, how can we ever be sure of anything?” They asked; “with-
out sound reasoning, how are we to survive; and without a firm view of moral
good, what is worth doing?” Everything they believed worthwhile seemed
destroyed by the seminar. (Gergen, 2009, p. 31)

Although Gergen does not directly comment upon this, I suspect that he was
probably happy to have some students who had listened carefully enough to
be disturbed by the nature of the material presented in his class. Often con-
structionism and the supporting material presented in this chapter are seen as
so upsetting that they are received by the listener in a manner similar to the
heads of the investment firm in the Kahneman vignette: they offered polite
comments, vacant stares, and essentially communicated their belief that the
material was so overwhelming that it must be discarded immediately. Put
simply: if constructionism and all its implications are fully integrated into
one’s worldview, such integration requires a complete and radical rewriting
of one’s core beliefs. Moreover, such acceptance can result in being treated
like a “deviant.” Individuals who have pierced the veil of constructed reality
become threats; and true threats to the social order must be marginalized at
best and expelled at worst.
Postmodernism not only deconstructs one’s worldview, all values based on
that worldview also come into doubt. Values connect to emotions and pas-
sions, and constructionism threatens all of these. Gergen comments:

Perhaps the most heated attack against constructionist views is directed against its
moral and political posture. As it is said, constructionism has no values; it seems
to tolerate everything and stand for nothing. Worse, it discourages a commitment
to any set of values or ideals; all values are “just constructions.” Constructionism
fails to offer any social criticism or directions for change. I first became aware
of the bitterness of this critique during a lunch with a Jewish philosopher friend.
100 Chapter 3

As I tried to explain constructionist ideas to him, he responded with anger, and

announced he could no longer eat with me. My constructionist ideas, he said, did
not condemn the Holocaust. In effect, constructionists would simply go along
with the Nazis. Such tolerance is morally repugnant. Another hour of dialogue
was needed to re-cement our friendship. (2009, p. 167)

One who truly integrates these ideas finds herself adrift in the ocean of relativ-
ism and chaos with no solid sense of right and wrong. It should come as no
surprise that this view of reality—a deconstructed, deprogrammed kind of free-
dom—has been repeatedly rediscovered and discussed across history and cul-
ture, particularly in religious and philosophical spheres. It is sometimes called
the “secret knowledge” in mystical traditions. It is secret not because it has
been hidden; on the contrary, it is discussed in one form or another in almost
all spiritual traditions. Rather, it is secret because it is simultaneously repellant
to most people in the culture and can be used for exploitation by others.
A modern example of a group who embodied some of these constructionist
dilemmas is Bagawan Shree Rajneesh and his dynamic meditation move-
ment. Rajneesh believed and preached a philosophy of deconstructionism and
liberation. Since his analyses proved that all values and conventions were the
result of social programming, real liberation required his followers to feel,
think, and act in a way that showed they were beyond this programming. His
most famous meditation technique, dynamic meditation, asked the practitio-
ner to directly experience the chaotic and unformed nature of the universe;
from the outside this looked like people walking in circles while making
spontaneous movements and meaningless sounds. His practitioners flouted
traditional rules and preached that operating outside of social boundaries was
a path to liberation. They used drugs, had promiscuous sexual encounters,
practiced limited levels of violence in certain situations, encouraged displays
of material wealth, and were free to do virtually anything that demonstrated
that their consciousness was unaffected by traditional programming.
Not surprisingly, Rajneesh’s movement was controversial from the begin-
ning; resulted in many stories of individuals who were traumatized and/or
violated; had just as many stories of narcissists and sociopaths being drawn to
and exploiting the movement; and finally attracted the attention of the police
who essentially terminated the community.
Clearly the full implications of constructionism are always dangerous, both
to the social order and to the individuals who practice the beliefs. When “all
that is holy” can be attacked and discounted, the attackers may win, but they
enjoy a pyrrhic victory. They may be right but what good can come from their
analyses and discussions?
For the psychotherapist, the dilemma is obvious. Constructionist ideas may
feel more accurate than existing beliefs but there is danger in their adoption.
 Social Constructionism 101

Psychotherapists already wrestle with their “right” to change clients and to

urge one course of action above another. It is true that many therapists argue
that a psychologist’s “right” to make a recommendation is derivative: the
client gives power to the therapist as a byproduct of coming into the office
and asking for help. Even with this qualification, constructionism operates
to undercut a therapist’s ability to urge one direction over another; all of the
therapist’s values become questionable and there is neither a safe center nor
any solid position that allows the exercise of power and choice in guiding
clients. Constructionism may be liberating, but at the end of the day it leaves
us more battered and confused than we were at the beginning.
Returning to the movie The Matrix (1999) at one point the protagonist
is confronted by the wisdom figure Morpheus and asked whether he really
wants to wake up and see Reality as it is. Along with this invitation, however,
Morpheus includes an implicit warning: waking up will not be comfortable.
It will have its terrifying moments and the awakened self loses stability, cer-
tainty, and predictability.

This is your last chance. After this, there is no turning back. You take the blue
pill—the story ends, you wake up in your bed and believe whatever you want
to believe. You take the red pill—you stay in Wonderland and I show you how
deep the rabbit-hole goes. (Silver, Wachowski, & Wachowski, 1999)

At this point, the reader might be feeling two opposing emotions. On the one
hand, there can be a level of intoxication, exhilaration, and freedom as a result
of the constructionist analysis. If everything is “made up,” the therapist has
access to levels of creativity and spontaneity unavailable to the practitioner
who continues to be entranced by cultural conditioning and professional pro-
gramming. On the other hand, the constructionist is never far from the cold
winds of the Abyss. Along with freedom and empowerment come simultane-
ous doubts. If it’s “all made up” then what does anything matter? What can I
do that makes any kind of difference? And where is the meaning in all of it?

NOTE

1. For a detailed discussion of constructionism versus realism in psychology,

please see Held’s Psychology’s Interpretive Turn. Held not only contrasts modern and
postmodern perspectives on psychology, she devotes a great deal of attention to vari-
ous theorists who have attempted to articulate the stance of this book: reality is both
constructed and fundamental. This is an easy, common sense answer; however, as
Held points out, holding this position becomes challenging when one explores all the
philosophical implications of blending the opposites.
 Chapter 4

A Place to Stand

Give me the place to stand, and I can move the earth.

—Archimedes, The Works of Archimedes (1897)

The last two chapters provide a description of Reality B. The Abyss, with its
chaos and meaninglessness, is the primary experience. In response, humans
construct social realities aimed at reducing anxiety and providing stability.
System 1 and social reinforcement make constructed reality feel like funda-
mental reality. Awareness of this process leads to the promise of postmod-
ernism: fluidity and freedom; unfortunately, these gifts come with the dark
corollaries of relativism, absence of core values, and a sense of being adrift in
chaos. Particularly for therapists, who are involved in making judgments and
effecting change, it is vital to have a place to stand—a sense of some sort of
meaning running through the chaos.
Looking for the threads of meaning pervading existential chaos is one of
the primary purviews of the discipline of existential theology. Paul Tillich,
arguably the most prominent existential theologian of the twentieth century,
particularly focused on the intersection of chaos and meaning. His most intel-
lectually rigorous work is his Systematic Theology, but fortunately for us, he
also wished to make his ideas accessible to the lay person. Hence he preached
regularly and wrote a series of shorter books designed for the man-in-the-street.
Tillich was a contemporary of Becker and was in his prime in the post–World
War II environment of existential doubt, burgeoning postmodern thought, and
the implicit despair inherent in the recent deaths of millions of human beings.
One of his shortest books, entitled Dynamics of Faith (1957), is particu-
larly relevant to the existential challenges posed by postmodernism. Examine
the opening paragraph of the book.

103
104 Chapter 4

Faith is the state of being ultimately concerned: the dynamics of faith are the
dynamics of man’s ultimate concern. Man, like every living being, is concerned
about many things, above all about those which condition his very existence,
such as food and shelter. But man, in contrast to other living beings, has spiri-
tual concerns—cognitive, aesthetic, social, political. Some of them are urgent,
often extremely urgent, and each of them as well as the vital concerns can claim
ultimacy for human life or the life of the social group. If it claims ultimacy it
demands the total surrender of him who accepts this claim, and it promises total
fulfillment even if all other claims have to be subjected to it or rejected in its
name. (p. 1)

In his first paragraph, Tillich presents the basic principles which run through-
out his book. Man is a “meaning-creating” animal. Meaning for Tillich is
operationalized as “ultimate concern.” He argues that every human has an
ultimate concern—whether they are conscious of it and can articulate it or
not. This certainly dovetails nicely with Kahneman’s sense that System 1
operates continuously to make coherent sense of reality and existence. Kahn-
eman would probably argue that humans cannot disable System 1 and func-
tion without this coherent map of Reality. In that sense, he would agree that
man is the “meaning-creating” animal.
This ultimate concern often evolves as one moves through life. It can be
oriented toward the “vital concerns” like food and shelter but, as those con-
cerns are satisfied, it reorients toward higher level concerns—concerns con-
nected to safety, accomplishments, recognition, ideals, and spirituality. Most
importantly, the ultimate concern “demands total surrender”; for example, if
success or money is one’s ultimate concern, one will work day and night, and
sacrifice relationships and even health, in the name of fulfilling one’s goal.
The ultimate concern implicitly promises ultimate happiness. To one who is
pursuing an ultimate concern, there is the sense that while one is pursuing it
they are on a “right” path and that, upon achieving it, they will experience
happiness, safety, and total fulfillment.
In addition to placing meaning and the unconditional concern at the center
of man’s being, Tillich is providing a new definition for the word “faith.” It
is not, as it is normally defined, a belief in something without proof; rather,
it describes the relationship between the individual and his ultimate concern.
The hope is that if the ultimate concern is fulfilled, one will be happy, content,
and living life correctly. Obviously such beliefs have to be “faith based” since
no one can promise—with authority—that fulfilling any goal will result in
perfect happiness and contentment. Yet individuals implicitly have this faith
that their ultimate concern will provide these things. Recalling all the times
one has said, “if I can just . . .” (get the job, have the relationship, pass the test,
own the house, recover from the disease), virtually everyone has a personal
experience of an encounter with their own ultimate concern.
 A Place to Stand 105

Tillich’s next proposal is that ultimate concerns can be ranked on a hierar-

chy of authentic versus idolatrous faith. Not surprisingly, he emphasizes the
common sense arguments that shallow and ephemeral ultimate concerns will
lead to disappointment and confusion. While they lead to disappointing ends,
a material ultimate concern still makes the demands of any ultimate con-
cern—sacrifice of our entire life. However, these ultimate concerns cannot
and will not deliver on their implicit promises of happiness and fulfillment.
Obviously Tillich’s arguments are backed up by hundreds of stories and anec-
dotes with messages like: “money and success won’t make you happy. Don’t
follow their siren songs to the ruination of your life.”
Of course, these sorts of ultimate concerns are not idolatrous at certain
moments in a person’s life. One definition of a successful passage of the
adolescent/adult transition is that the young person acquires a desirable mate
and finds work that is respected by others and fairly compensated. Achieving
those goals is often the ultimate concern of a young person in the midst of
their transition to adulthood. These concerns only become “idolatrous” if a
person continues to elevate them above all others after she has achieved them
and the developmental passage has been completed successfully. An obvious
example is a classic midlife crisis where a man leaves his marriage, gets a
red sports car and a girlfriend who is twenty years his junior. He is confused
about how to move forward so attempts to recreate an earlier success. That
success was healthy when he was twenty-five but is idolatrous now. Simi-
larly, it is often on one’s path to achieve a certain level of financial security
for oneself and one’s family; however, the fixation on security, and the
continued working to save more and more in the fruitless pursuit of perfect
safety, is idolatrous.
In this sense, Tillich’s system of authentic versus idolatrous faith is hierar-
chical and evolutionary. He believes that every ultimate concern, when it is
encountered and experienced with a healthy and present attitude, leads to a
higher level ultimate concern. Staying in any stage too long opens one to idol-
atry. Interestingly, it can also be argued that attempting to skip ahead creates
another form of idolatry. In psychotherapy, for example, a victim of violence,
injustice, or abuse is enjoined to work through their fear and anger before
trying to achieve understanding, compassion, and forgiveness. Some clients,
who are being urged by well-meaning others to jump ahead to forgiveness
without regaining personal safety and personal power, inappropriately move
into what might be called an idolatrous forgiveness, a forgiveness where the
client tries to feel and act forgiving while unresolved emotions hinder her
ability to achieve authentic compassion for the perpetrator.
Given that Tillich believes that to be human is to have an ultimate concern,
he essentially sees man as homo religiosus. Are the rationalist, the scientist,
and the atheist—who formally disavow all versions of God—just as “faith
106 Chapter 4

based” as the theist? Tillich argues in the affirmative, of course. The dedica-
tion of the rationalist to clarity and fearlessness in thought, of the scientist to
discovering truths about the Universe, and the atheist to removing all cultural
programming are clearly ultimate concerns in Tillich’s view. He would, of
course, argue that these are transitory ultimate concerns; ultimate concerns
that are valid at one point in the developmental cycle, ultimate concerns that
need to evolve to a higher level as one grows in wisdom and awareness. Be
that as it may, Tillich not only includes the rationalists, scientists, and athe-
ists, he even includes the skeptics and the cynics.
Becker (1997), writing from a much different perspective, agrees with Til-
lich that all heartfelt philosophies double as religious systems. He believes
that society attempts to create meaning by reenacting a hero system—a living
myth that points toward the infinite. In this sense, Becker argues that every
society has a religious theme even if—as in communism—the society is
formally atheistic. The “heroic” vision of an egalitarian society appears to be
idealism but, to Becker, it is simply another way to deny death. What Tillich
calls ultimate concerns, Becker sees as ultimate rationalizations and ultimate
denial. But both agree that every idealized social system attempts to point
beyond itself and, hence, is “religious.”
Tillich continually emphasizes the “ultimate” in the term ultimate concern.
Ultimacy implies spiritually and Tillich is not shy about using religious lan-
guage to grasp the essence of the relationship to the ultimate concern.

[E]verything which is a matter of unconditional concern is made into a God. . . .

Success as ultimate concern is not the natural desire of actualizing potentialities,
but as readiness to sacrifice all of the values of life for the sake of a position
of power and social predominance. The anxiety about not being a success is an
idolatrous form of the anxiety about divine condemnation. Success is grace; lack
of success, ultimate judgment. (p. 44)

In introducing religious language into the discussion, Tillich deepens the

emotional response to the concept of the ultimate concern. He argues that
every ultimate concern is a God to the one who is committed to it, to the one
who has faith in it. Similarly, the individual experiences success as “grace,”
a free and spontaneous outpouring of well-being, support and a sense of
righteous endorsement that one is on one’s path. Finally, lack of success is
experienced as “ultimate judgment” that the person is a failure. The failure to
achieve one’s ultimate concern casts one into darkness and despair and results
in a profound sense of self-abnegation. Think of certain investors who threw
themselves out the window during the market crash of the 1920s. They would
still have had a middle class life style but they preferred death over accepting
the loss of their idolatrous ultimate concern.
 A Place to Stand 107

Tillich’s path—as we have discussed it so far—is hierarchical: one ascends

an increasingly spiritual and idealistic path with one ultimate concern leading
to the next. Tillich however is not content with such a simple model and intro-
duces the concept that every part of the path toward the ultimate is equivalent
to every other point. In other words, his model is both hierarchical and flat.
He introduces his nonhierarchical view with the idea that when one walks
an authentic path, the first step on the path participates in the terminus just
as much as the middle or the last step on the path. Since one can never fully
arrive at the ultimate, every step on the path, no matter how near or far, par-
takes equally in the final goal.
Moreover, the path itself is not simply a “sign” that points toward the
ultimate; rather, it is a “symbol” that participates in the ultimate. This dif-
ference between sign and symbol is central to Tillich. To illustrate this, he
uses the symbol of the national flag. On the battlefield a soldier might risk
death to dash out into the open and retrieve a fallen flag. Members of a nation
experience visceral anger and a sense of violation when their flag is burned
or debased. Contrast that with a sign; write “United States of America” on a
large piece of plywood and put it out in the open in a battlefield. One cannot
imagine a soldier risking his life for this piece of plywood with writing on it.
Both the flag and the plywood signify America yet only one is a symbol that
participates in it, only one participates in an ultimate concern that calls on one
to risk one’s life.
Tillich states that symbols do not last forever; they rise and fall with the
vagaries of the individual and the collective unconscious. But while they are
living symbols, they not only point to the ultimate concern; in some sense,
they are the ultimate concern. Being fully present with a symbol of the ulti-
mate is equivalent to having an experience of the ultimate. And it is not an
intellectual experience like one would have with a sign or a rational discus-
sion, it is a full, centered experience of the total person.
With his discussion of symbols, Tillich “flattens” his hierarchical path. Since
every symbol along the path fully participates in the terminus of the path, it
stands to reason that an eighteen-year-old who is experiencing romantic love
is having a spiritual experience that is equivalent to a fifty-five-year-old on a
week-long meditation retreat. At this point, the Tillichian path becomes para-
doxical. It continues to be hierarchical in that one advances developmentally
on the continuum of idolatrous/authentic but it is also “flat” in that any person
walking at any point on the path has the opportunity to participate equally in
the ultimate. The paradoxical nature of the path gives room for the opportuni-
ties to learn, grow, and evolve, but also endorses the power of being fully in
the present and the sense that the ultimate is always only a breath away.
Not coincidentally, in defining his path as both hierarchical and flat,
Tillich provides the foundation for a paradoxical view of the therapeutic
108 Chapter 4

relationship—a relationship that is both one up and egalitarian. In other

words, the therapist in the relationship can be a hierarchically superior guide
and, simultaneously, honor the essential equality with the client. Similarly he
can paradoxically feel that his judgment is more accurate than the client’s at
one moment while, in the next moment, deferring to the inner wisdom of the
client in terms of determining her own path.
This also supports the common therapeutic idea that therapy essentially
consists of functioning as midwife to the client’s inner truth. In Tillich’s
hierarchy, the true faith of every individual participates fully in the ultimate
and hence, is “holy.” In this sense, the therapist is required to orient treatment
around the ultimate concern of the client. If it is idolatrous, the therapist’s
work is to expose the futility of such a path and, eventually, to help the cli-
ent orient to something more real and rewarding. This also implies that each
person has a unique path that exists for them alone. The ultimate presents in
many ways depending on the nature and needs of the client. The therapist is
required to honor this uniqueness and to structure the therapy to serve the
client’s true ultimate concern.

FAITH AND DOUBT

First, believe in the world―that there is meaning behind everything.

­—Swami Vivekananda, The Complete Works
of Swami Vivekananda (1907)

Tillich’s system begins with the definition of man as a meaning-creating

animal and then analyzes the path as authentic/idolatrous and paradoxically
hierarchical and flat. This is helpful to therapists in that it allows them to use
judgment—“this choice or feeling is more authentic”—while still deferring
to the client’s own truth—“we are being guided by your inner wisdom.”
So far, so good. However, since Tillich’s path points toward the ultimate,
it immediately raises the classic issue: is there really an ultimate or are we
simply programmed to invent an ultimate secondary to our fear of death and
meaninglessness?
Tillich addresses this basic question by developing new definitions of both
faith and doubt. Instead of seeing them as contradictory forces, he believes
that one is a necessary complement to the other.

All this is sharply expressed in the relation of faith and doubt. If faith is under-
stood as belief that something is true, doubt is incompatible with the act of
faith. If faith is understood as being ultimately concerned, doubt is a necessary
element in it. It is a consequence of the risk of faith. (pp. 17–18)
 A Place to Stand 109

With this quote, Tillich moves away from the traditional definition of faith as a
belief in something without proof to faith as a relationship to the ultimate con-
cern. And he specifically states that in a relationship with an ultimate concern
there is an ecstatic and transcendental quality of choosing and committing but
there is an equivalent force of doubt and risk. With Tillich’s Faith, one is never
completely safe. Because we live in the world we are subjected to the powers
of nonbeing which are the heritage of everything finite. Regardless of how
committed or wholehearted one is in the choosing of the ultimate concern, the
experience of doubt is just around the corner. And as one experiences doubt,
one is required to choose daringness and courage in the face of possible failure.
A concrete example helps to illustrate Tillich’s arguments about the sym-
biotic union of doubt and faith. Martin Buber was famous as an existential
philosopher and a Jewish theologian. He had a series of repetitive dreams,
which he named the dream of the double cry. The dreams were set in a kind of
primitive world. They begin differently but include an event—like an animal
attack—that must be resisted.

Then suddenly the pace abates: I stand there and cry out. In the view of the
events which my waking consciousness has I should have to suppose that the
cry I utter varies in accordance with what preceded it, and is sometimes joyous,
sometimes fearful, sometimes even filled both with pain and with triumph. But
in my morning recollection it is neither so expressive nor so various. Each time
it is the same cry, inarticulate but in strict rhythm, rising and falling, swelling
to a fullness which my throat could not endure were I awake, long and slow,
quiet, quite slow and very long, a cry that is a song. When it ends my heart stops
beating. But then, somewhere, far away, another cry moves towards me, another
which is the same, the same cry uttered or sung by another voice. Yet it is not
the same cry, certainly no “echo” of my cry but rather its true rejoinder, tone
for tone not repeating mine, not even in a weakened form, but corresponding to
mine, answering its tones—so much so, that mine, which at first had to my own
ear no sound of questioning at all, now appear as questions, as a long series of
questions, which now all receive a response. The response is no more capable
of interpretation than the question. And yet the cries that meet the one cry that is
the same do not seem to be the same as one another. Each time the voice is new.
But now, as the reply ends, in the first moment after its dying fall, a certitude,
true dream certitude comes to me that now it has happened. Nothing more. Just
this, and in this way—now it has happened. (Buber, 2014, p. 1)

Buber had the dream in this form several more times until, at last, the dream
took on a new form. It began in the same way—primitive setting, animal
attack, and a cry—but this time there was no answer, no response.

Awaited, it failed to come. But now something happened with me. . . . I exposed
myself to the distance, open to all sensation and perception.
110 Chapter 4

And then, not from a distance but from the air round about me, noiselessly,
came the answer. Really it did not come; it was there. It had been there—so I
may explain it—even before my cry: there it was and now, when I laid myself
open to it, it let itself be received by me. I received it as completely into my
perception as ever I received the rejoinder in one of the earlier dreams. If I were
to report with what I heard it I should have to say “with every pore of my body.”
As ever the rejoinder came in one of the earlier dreams this corresponded to and
answered my cry. It exceeded the earlier rejoinder in an unknown perfection
which is hard to define, for it resides in the fact that it was already there.
When I had reached an end of receiving it, I felt again that certainty, pealing
out more than ever, that now it has happened. (Buber, 2014, p. 1)

At the conclusion of this series of dream experiences Buber had the obliga-
tion to make sense of them and to integrate them into his life. He was free to
see them as the result of social conditioning and spiritual expectations and
dismiss them as essentially meaningless. Conversely, he could interpret them
as a connection with the “wholly other”—with the ultimate—and take it as an
affirmation of his spiritual identity. Following an experience like this dream
series, there is no higher authority one can call on to determine whether they
should be dismissed as a conditioned response or accepted as an affirmation
of the ultimate. And whichever way Buber chooses to interpret them, he will
be picking one form of ultimate concern over another: the ultimate concern
embodying deprogramming and aloneness or the ultimate concern embody-
ing the numinous.
If he chooses to dismiss the dreams as the result of social programming,
he is simultaneously affirming his essential alienation—his aloneness as he
moves through the world of the absurd. In Denial of Death (1997), Becker
comes to just this conclusion. After deconstructing all culture and meaning
as inventions designed to stave off the terror of mortality, Becker rests in
the honesty of his analysis and in his courage to abandon all comforting
illusions.

The prison of one’s character is painstakingly built to deny one thing and one
thing alone: one’s creatureliness. The creatureliness is the terror. Once admit
that you are a defecating creature and you invite the primeval ocean of creature
anxiety to flood over you. . . . What does it mean to be a self-conscious animal?
The idea is ludicrous, if it is not monstrous. It means to know that one is food
for worms. This is the terror: to have emerged from nothing, to have a name,
consciousness of self, deep inner feelings, an excruciating inner yearning for life
and self-expression—and with all this yet to die. . . .
The man with the clear head is the man who frees himself from those fantas-
tic “ideas” . . . and looks life in the face, realizes that everything in it is prob-
lematic, and feels himself lost. And this is the simple truth—that to live is to feel
oneself lost—he who accepts it has already begun to find himself, to be on firm
 A Place to Stand 111

ground. Instinctively, as do the shipwrecked, he will look round for something

to which to cling, and that tragic, ruthless glance, absolutely sincere, because it
is a question of his salvation, will cause him to bring order into the chaos of his
life. These are the only genuine ideas; the ideas of the shipwrecked. All the rest
is rhetoric, posturing, farce. He who does not really feel himself lost, is without
remission; that is to say, he never finds himself, never comes up against his own
reality. (pp. 87–88)

To Becker, everything past the feeling of the shipwrecked, the lost, is “rheto-
ric, posturing, farce” (1997, p. 89). He has made his choice, made his leap of
faith, and embraced the ultimate concern of being free, free to experience the
Abyss without remission. Conversely, as Buber affirms the meaning of the
dreams as a connection with the ultimate and an affirmation of his spiritual
nature, he achieves a place to stand, a spiritual center which forms the foun-
dation of his decisions, choices, and values.
Buber’s dreams are simply one example of an experience which in the
final analysis must be accepted as an affirmation of the ultimate or dismissed
as programming. Other examples include watching the face of a sleeping
child, falling in love, walking on the beach at sunset, experiencing the sea-
son of spring, having a peak experience that all things are connected and
you are a part of everything, or being moved and inspired by a sermon or a
spiritual talk.
Once one has followed the analyses in chapters 2 and 3, and seen the Abyss
and the constructed nature of reality, that person is forced into a decision: Til-
lich or Becker—an alignment with the ultimate or some form of abiding in
the Abyss. Both choices embody ultimate concerns. More importantly, both
choices are intertwined with doubt. Becker can never be certain—twenty-four
hours a day—that no meaning runs through life and that the best one can do is
have an existential acceptance of chaos. Tillich and Buber are never without
doubt that their lofty ideals are mere constructs—invented ideas created to
shelter them from the cold winter night of the Abyss.
This dilemma is related to the concept of free choice as developed by
Sartre and other existentialists. However, Sartre diverges from Tillich in that
he believes that the connection/alienation dilemma has been settled; he has
examined the alternatives and, to him, it is clear that we are alone. “Every
existing thing is born without reason, prolongs itself out of weakness, and
dies by chance” (Sartre, 2013). Accepting our aloneness, Sartre believes
that the best one can do is to impose meaning on essential meaninglessness
by “choosing.” “Life has no meaning a priori. . . . It is up to you to give it
a meaning, and value is nothing but the meaning that you choose” (Sartre,
2007, p. 51). Orson Welles also accepts basic aloneness and talks about creat-
ing the illusion of connection.
112 Chapter 4

We’re born alone, we live alone, we die alone. Only through our love and
friendship can we create the illusion for the moment that we’re not alone.

Buber and Tillich disagree. They accept that there is a case to be made for
alienation but argue that it is not clear that aloneness is the “truth” and con-
nection is “manufactured” through an act of will. Tillich and Buber believe
connection is as much a part of the human experience as aloneness and alien-
ation. They reject Sartre’s confidence that connection and meaning only exist
in constructed reality. They grant that Sartre’s choice between the alternatives
is as valid as their own but deny that it represents higher truth or a more accu-
rate picture of reality.
The existentialists argue that their choice is not only supported by experi-
ence, it also takes a high degree of courage to accept it—to continue moving
bravely forward in spite of one’s aloneness and a fundamental meaningless-
ness. To frame love and connection as illusion is to leap courageously into
a life of existential despair. If it is this hard, it must be true. Conversely,
adopting Tillich’s perspective is seen as an escaping to a manufactured and
seductive comfort because one lacks the moral character to face one’s essen-
tial alienation.
Buber and Tillich respond that choosing to see life as meaningless is, in
actuality, the coward’s option. Affirming connection and purpose require an
active stance—a stance that consciously resists the seductive whisperings of
narcissism and self-centeredness. Is it easier “to be my brother’s keeper” or to
surrender to the fear that we are always alone? For the conscious individual at
the edge of the Abyss either choice is ultimately challenging and either choice
requires boundless courage.
The only easy choice is to remain unconscious—to deny the constructed
nature of reality. It is easy for atheists to reject spirituality as they point out
the logical inconsistencies of spiritual metaphors. Similarly it is easy for the
believer—using the old definition of “faith” as “belief”—to assert what he
has been taught since childhood, the comforting credo endorsed by all who
surround him. In sum, the first choice is awake versus asleep—accepting con-
structed reality as “real” or rejecting all that is programmed. Only those who
arrive at the edge of the Abyss actually make a spiritual choice.
There is an interesting and important contribution to this dilemma from
recent work in the field of evolutionary theory. For decades school children
have been taught Darwin’s dictum of the survival of the fittest. This principle
has bearing on our Buber/Becker dilemma. If humans are genetically selected
for selfishness—and those who are focused on “getting mine” reproduce at
higher rates than the more altruistic—then evolution votes in the direction
of Becker. Buber is simply trying to paper over a competitive, disconnected
world with a sweet-smelling, consolatory theory.
 A Place to Stand 113

However, new advances in evolutionary theory are replacing the simple

principle of survival of the fittest. Edward Wilson, one of the authors of the
new theory, states that we have actually been selected for both altruism and
for selfishness. According to his analysis, since humans are highly social and
tend to band together and form groups, there is competition and evolutionary
selection at both the group level and the individual level.

Probably at this point, during the habiline period, a conflict ensued between
individual-level selection, with individuals competing with other individuals
in the same group, on the one side, and group-level selection, with competition
among groups, on the other. The latter force promoted altruism and cooperation
among all the group members. It led to innate group-wide morality and a sense
of conscience and honor. The competition between the two forces can be suc-
cinctly expressed as follows: Within groups selfish individuals beat altruistic
individuals, but groups of altruists beat groups of selfish individuals. Or, risking
oversimplification, individual selection promoted sin, while group selection
promoted virtue. (Wilson, 2015, pp. 32–33)

The Buber/Becker debate concerns whether humans are essentially alone or

essentially connected. Wilson makes the case that humans are evolved to feel
both selfishness and altruism simultaneously and profoundly. This concept
is highly similar to Tillich’s argument that one can never choose connection
without doubting its final truth and never choose alienation without being
besieged—at least occasionally—by a sense of unity. Wilson’s evolutionary
theory has interesting parallels with Tillich’s hierarchy in that early devel-
opmental concerns about individual success evolve into more other-centered
goals later on. Of course Maslow’s and Kohlberg’s hierarchies have similar
developmental steps.
Wilson himself is quite clear that, for him, this altruism/selfish duality
does not imply anything spiritual. One of his books is entitled The Meaning
of Human Existence and his primary argument is that the altruism is more
an accident of evolution than evidence of connection. When the Dalai Lama
states, “Our ancient experience confirms at every point that everything is
linked together, everything is inseparable,” Wilson shakes his head and rec-
ommends studying evolution more carefully. Yet at other parts of the book,
Wilson comments that he chooses to behave altruistically and uses climate
change as the concrete example. Wilson believes that the human race is in the
midst of an evolutionary challenge; without sufficient individuals choosing
their altruistic side, we are headed for a rough future.
Wilson’s pragmatic choosing of altruism leads fairly directly to an equiva-
lent choice in psychotherapy. Therapists, when working with clients, rarely
or never support the decision to disconnect, to go it alone, and to refuse rela-
tionship with others. This choice to be alone is almost always framed as “the
114 Chapter 4

client did not have the courage and ego strength to choose to connect. They
took the easy way out—to stay armored and alone.” Conversely overcom-
ing the fear of the other and saying “yes” to authentic connection is seen as
embodying healthy risk taking, consciousness, and love.
The importance of this “choice point” in psychotherapy should not be
underestimated. While the consensus of a helping profession to choose con-
nection over alienation hardly “proves” that connected is the “right answer”
in terms of Buber’s dilemma, it does suggest that therapy, healing, and per-
sonal development are inextricably intertwined with the “connected” choice.
Psychotherapists begin with an implicit assumption about the value of help-
ing others. On a pragmatic level, as well as a spiritual one, they have already
made their choice.1
At the end of the day, there can be no certainty. Each individual has their
own experience of Sartre’s nausea, Wilson’s compelling arguments, and
Buber’s dreams. Expecting definitive answers requires regression to the old
definition of faith: something that is believed without proof. There can be
no proofs here. Instead there is only faith, activated by courage in the face
of non-Being, and accompanied by breakthroughs of doubt and existential
despair. Tillich (1957) comments:

Out of the element of participation follows the certainty of faith; out of the ele-
ment of separation follows the doubt in faith. And each is essential for the nature
of faith. Sometimes certainty conquers doubt, but it cannot eliminate doubt. . . .
Since the life of faith is life in the state of ultimate concern and no human being
can exist completely without such a concern, we can say: Neither faith nor doubt
can be eliminated from man as man.
. . . Doubt is overcome not by repression but by courage. Courage does not
deny that there is doubt, but it takes the doubt into itself as an expression of its
own finitude and affirms the content of an ultimate concern. Courage does not
need the safety of an unquestionable conviction. It includes the risk without
which no creative life is possible. (pp. 100–101)

While there will never be a “proof” of God that eliminates doubt, the power
of the ultimate concern will always stand at the end of the day. Tillich argues
that it is necessary to embrace one ultimate concern to debate the truth of
another. At the end of the day, man is always endorsed as the meaning-
creating animal.

[F]aith is not a phenomenon beside others, but the central phenomenon in man’s
personal life, manifest and hidden at the same time. It is religious and tran-
scends religion, it is universal and concrete, it is infinitely variable and always
the same. Faith is an essential possibility of man, and therefore its existence is
necessary and universal. . . . Faith stands upon itself and justifies itself against
 A Place to Stand 115

those who attack it, because they can attack it only in the name of another faith.
It is the triumph of the dynamics of faith that any denial of faith is itself an
expression of faith, of an ultimate concern. (pp. 126–127)

NOTE

1. This does not imply that therapists avoid discussing existential aloneness with
clients or that they believe that anyone who experiences alienation is on the wrong
path. Since connection and alienation are both fundamental human experiences, they
necessarily exist in the psyche of every human and therapists recognize their essential
validity. However, when it comes to recommending that a client attempt to live life as
an isolated being suspended alone in an eternal sense of nausea and meaninglessness,
therapists inevitably step back and recommend instead that the client cultivate a sense
of connection, love, and meaning. Obviously the manner with which this is accom-
plished varies from client to client and timing is central, but the commitment of the
therapist to alleviate suffering makes their essential choice inevitable.
 Chapter 5

The Nomological Net

If you have built castles in the air, your work need not be lost; that is
where they should be. Now put the foundations under them.
—Henry David Thoreau, Walden (1854)

In order to use constructionism and Tillich’s hierarchy in a clinical context,

it is helpful to articulate a formal model—to describe Reality B explicitly.
Constructionists of course, always begin with the concept of a creative
chaos—the raw stuff of life which can be formed into diverse realities and
cultures. A culture, and by extension, a personal identity, needs to stabilize
this material to create an environment where reality is predictable and safe.
This stabilizing force is often visualized as a “Net”—a series of strands and
cross hatchings which connect one to the rest of the culture and which sta-
bilizes reality. The analogy can be made to a hillside of raw earth bereft of
plants because it has been graded recently. The hillside is stabilized with an
anti-erosion net until the roots of the seeded plants can take over the job; a net
of fiber or plant roots is required to restrain the relatively fluid hillside from
changing and altering shape with each rain storm.
By extension, each individual exists at the center of her own net with
strands going off in every direction. The purpose of this net, of course, is to
sustain the nature and structure of one’s personality across experiences, social
encounters, and time. As demonstrated in the earlier chapter on the Abyss,
identity is fluid and plastic, a fact which, when fully experienced, is equiva-
lent to falling into the Abyss. Stabilizing this fluidity is necessary for a sense
of personal safety and for social functioning.
The individual’s strands connect to virtually everything relevant to his
life: his body, his family, other individuals, his bank account, and important

117
118 Chapter 5

cultural ideas like the nature of government and religion. The strands are of
varying thicknesses and strength and change with the passage of time and in
the context of different experiences. Tillich, of course, would argue that one
of the primary strands is related to the person’s ultimate concern. This net
appears to be solid but is always inherently fragile; as Becker argues, the anx-
iety related to the existence of the Abyss is always prepared to break through
and to transform a person’s experiences and feelings in a rapid, irresistible,
and terrifying direction. Gilligan compares the Net to a concept of overlap-
ping filters. Simply replace “filter” with “thread” in the following quote.

There are many types of reality filters: neurological, cultural, familial, personal,
social, and so on. The body is a filter, family is a filter, educational background
is a filter, the social context is a filter. All are gateways through which con-
sciousness flows, translating information/energy into classical and human form.
Each filter has multiple dimensions—for example, a specific filter may carry
beliefs, histories, images, verbal languages, rules, images, defining narratives—
and each dimension can be set in many ways. For example, in your intimacy
map you may believe that you’re unlovable, or that you can enjoy intimacy, or
that intimacy is never fulfilling. . . . Of course, there are many filters operating
at many levels, so we don’t want to fall into the solipsistic trap of assuming that
your conscious thoughts singularly create the whole universe. You belong to a
culture, a family, a gender, social groups, and so forth. All these different levels
of identities are in play, each with their own filters, so the process is complex.
(Gilligan, 2012, p. 23)

And narrative therapists in particular see this Net as instrumental and funda-
mental to the definition of self. My self is not in me; rather, it exists in the
space between me and my entire environment—with everything in dialog
with me. “Who am I?” is best answered socially.

During the early 1930s, Mikhail Bakhtin, who was a Russian psychologist
and linguist, suggested that we are direct contributors to each other’s identity.
Bakhtin described a relational view of the self when he stated that “[I] get a self
that I can see, that I can understand and use, by clothing my otherwise invisible
(incomprehensible, unutilizable) self in the completing categories I appropriate
from the other’s image of me” (Clark & Holquist, 1984, p. 79). Bakhtin’s belief
is that the other plays a central role in constituting the individual’s self. And
without the ongoing relationship to the other, our selves would be invisible,
incomprehensible, and unusable. The other gives us meaning and a comprehen-
sion of our self so that we might possibly function in the social world (Liapunov
& Holquist, 1993). The knowledge we have of ourselves appears in and through
social practices—namely, interaction, dialogue, and conversation with others’
responses. (Madigan, 2012, Kindle Locations 1634–1647)
 The Nomological Net 119

For purposes of this book, we will call this net, the “Nomological Net” with
Nomos referring to the principle of order or law. The job of the therapist is
to help the client move from his current identity—his current position in the
Net—to a new one which is relatively free of symptoms, or more vital and
meaningful, or an evolutionary step along one’s path.
The Net is stabilizing and the Abyss is destabilizing. The Net is Apollo-
nian and the Abyss is Dionysian. The Net holds it all together and the Abyss
dissolves everything into primal chaos. When Abyss is used in this manner
it implies all of the forces of entropy: change, death, and developmental
processes.
The forces of the Abyss are usually characterized as terrifying and disin-
tegrative but, paradoxically, they can also be seen as freeing, liberating, and
empowering as well. Dionysian can be chaotic and destructive but change
is also necessary for adaptability, growth, development, and life itself. The
Abyss is a living contradiction. Typically, when the Abyss breaks through the
shielding aspect of the Net, the result is grief, confusion, meaninglessness,
and terror. Recall the beginning of the chapter on the Abyss which empha-
sized the relative power of negative life experiences.
Contrast that with Joseph Campbell’s view of the Abyss: “It is by going
down into the abyss that we recover the treasures of life. Where you stumble,
there lies your treasure” (Kain, 2011, p. 112). In that same vein, Buber repeat-
edly urges seekers to leap into the Abyss to achieve spiritual fulfillment.
Rumi tells us, “The cure for pain is in the pain.” And Jung, Hillman, and
Merton believe that psychopathology—while admittedly associated with pain
and suffering—when explored appropriately will often serve as a road into
meaning. This concept, that the breakthrough of the Abyss into normal life
can lead to epiphanies, spiritual experiences, and guidance, is precisely the
opposite of its typical reputation as a terrifying and demoralizing experience.
In this sense, the Abyss functions as an oracle.
The individual who can confront the Abyss directly has a power beyond
most of us humans, a freedom which surpasses those who fear it and try to
contain it. One of the classic definitions of a shaman—a definition which
crosses cultures and time—is the person who can visit the “other world” or
“the world of the dead” and return bearing gifts to the world of the living. In
this sense, the Abyss—when manifest as Dionysian or creative energy—is
the source of all that is new, fresh, progressive, and adaptive. The Hindus
characterized the dark side of the Abyss as Kali and Shiva: destroyers of
ignorance, divine forces which cut through all that holds us back. They are
terrifying and liberating simultaneously; it simply depends on whether one
can find a place to stand that is sufficiently solid, such a vantage point allows
one to experience the raw material of life and change with exhilaration and
120 Chapter 5

liberation instead of terror. The same force that terrifies us and cuts through
ignorance can also open the door to truth and inner peace.
Opposed to these forces are the forces of stabilization. This Apollonian
force is embodied by the conservative effort to keep it all together, to resist
falling apart, to preserve what is good. This force is particularly familiar to
family systems therapists who call it homeostasis: the tendency of a system
to revert to a previous form after being buffeted by the winds of change. The
power of the Abyss requires an equally powerful counterforce: homeostasis
is not a mild elasticity which is easy to overcome. It is resistant, persever-
ing, and powerful. The “light” side of the Apollonian stance manifests as
preserving what is best and making life predictable and fair, for example,
it is particularly important in the context of raising children. The dark side
is easily seen in the righteousness and anger of a “conservative” who, when
confronted by something beyond his control, chooses actions which extend
from fury and indignation to assassination and execution. Destabilization is
a very serious matter when one lacks a sufficiently strong place to stand; ter-
ror, doom, and a sense of imminent death are common results when one is
exposed suddenly and unwittingly to the Abyss.
While Apollonian forces are useful and necessary in a healthy culture or
family, stability is the enemy of the effective therapist. Stability implies a
continuation of the symptoms which brought the client into treatment. And
of course, not only will the client operate to stabilize her own position but it
is often true that the culture itself will work to stabilize the individual. The
therapist’s job is to be a provocateur, an unbalancing influence that helps the
individual alter the shape and nature of her Nomological Net into something
more effective, workable, and functional. Putting this in terms of Tillich’s
system, the therapist moves the client from an idolatrous fixation to a more
functional and fluid relationship with her ultimate concern.
From this description it is easy to conceptualize an individual’s Nomologi-
cal Net as strong or weak—hyper stabilized or fluid. A hyper stabilized iden-
tity is rigid with fear; the individual senses the looming Abyss and clutches
on for all they are worth. Conversely a fluid Net allows a person to adapt
easily to the inevitable changes and developmental processes that character-
ize life. A so-called unstable person—an individual who has labile moods
and flits from one center point to another—only appears fluid; in reality, their
apparent instability is in itself a hyper stability. Typically the more unstable,
the more difficult it will be for such a person to change appropriately and in
alignment with an ultimate concern.
In addition to this hyper stabile/fluid dimension, there is another dimen-
sion worth considering: cultural integration versus alienation. From a con-
structionist point of view, the primary task of child rearing is to inculcate the
worldview of the culture. Success or failure in this regard can vary widely
 The Nomological Net 121

across individuals, religions, social classes, and so on. To be a successful

member of the culture, one must not only “speak the language” in every sense
of the word, one must also believe that cooperating with others, deferring to
higher status people, and working hard will eventually result in happiness.
In a general sense, while there may be many subcultures, each of which can
be differentiated from the primary culture in varying ways, at the end of the
day there is one primary choice: become a member of the tribe or live as an
outsider. And, of course, to motivate individuals to “join up” there are various
incentives as well as implicit and explicit penalties and punishments if one
chooses to be an outsider.
Individuals vary by how well they are integrated into the culture from “pil-
lars of the community,” to the “upwardly mobile,” to normal individuals. And
then there are the outsiders: the disabled, the rule breakers and sociopaths,
and the liminal. On the outer edge of the culture live those who have never
integrated—the homeless, the severely mentally ill, and the oppressed—and
those who were in the tribe but have been pushed toward the fringes—the
underemployed, the recently divorced, and the disabled. All of those who
live on or near the edge are in daily dialog with the Abyss; often they are
suspended in it full time. And, of course, one would expect that many of those
at the edge of the culture have hyper stabilized identities.1
Tillich’s analysis adds a vertical dimension; individuals are not only mea-
sured in terms of the center or being near the edge, they are also measured
hierarchically in terms of the true/idolatrous nature of their ultimate concern.
Often the person at the center of the culture is the same person who is the
most idolatrous. It is easy to become attached—idolatrous—when one is suc-
cessful by cultural definitions. The New Testament quote about it being as
difficult for a rich man to enter heaven as for a camel to pass through the eye
of a needle is relevant here.
Nietzsche’s continuum of Apollonian versus Dionysian will be central
to many discussions in this book. Everything that supports the solidity and
stability of the net is Apollonian; all that is conducive to change, fluidity, and
creativity is Dionysian. Apollonian change is gradual, logical, and expected.
Conversely, Dionysian change is often discontinuous, abrupt, and occurs via
altered states. Since psychotherapists are primarily focused on change, the
Apollonian forces of stability usually provide resistance and the Dionysian
forces of personal growth are usually allies. Of course, there are many healthy
forms of Apollonian change and, as we will discuss below, psychology is
often more comfortable with championing gradual and expected change that
implicitly supports the Net than the sometimes jarring and unsettling process
that often characterizes Dionysian change.
All of the concepts discussed in this section taken collectively form a
geography of constructed reality. The most important concept is the constant,
122 Chapter 5

ongoing dialog between the Abyss and the Net. An awareness of the dia-
log between these primary forces and a graceful ability to work with their
nuances can be symbolized by the concept of dancing with the Abyss.

THERAPY AS RITUAL

Truths are illusions of which one has forgotten they are illusions.
—Friedrich Nietzsche, The Complete Works
of Friedrich Nietzsche (1911)

The research tells us that what we do in the room with clients works; virtu-
ally every system and every technique generates the expected mild, positive
effect. Given this unity of outcomes, there have been a number of common
factors theories that attempt to identify the shared elements across approaches
that are most responsible for change. We have already reviewed the most
famous common factors theory—the concept that a healthy therapeutic rela-
tionship underlies all change.
Something happens in the room beyond the relationship. Traditionally
these interactions are called “techniques”; however, with the literature
explicitly supporting the concept that techniques have no inherent power, we
require a more comprehensive common factors theory that fits with a con-
structionist analysis. Fortunately, Jerome Frank proposed just such a theory
over fifty years ago.
When he initially proposed his theory, Frank was attempting to articulate a
model of change that could unite modern psychotherapy with other models of
change across cultures and history, models as diverse as shamanism, spiritual
mentoring, and faith healing. Writing in his classic work, Persuasion & Heal-
ing, Frank proposed that all therapy, whether modern, shamanic, or spiritual,
has four factors in common.
In our view, all psychotherapies share at least four effective features.

• An emotionally charged, confiding relationship with a helping person;

• A healing setting;
• A rationale, conceptual scheme, or myth that plausibly explains the
patient’s symptoms;
• A ritual or procedure that requires the active participation of both patient
and therapist and that is believed by both to be the means of restoring the
patient’s health. (Frank & Frank, 1993, pp. 40–43)

Frank’s model begins with the most well-known factor, the therapeutic
alliance. He then veers toward constructionism when he implies that the
 The Nomological Net 123

explanation for the symptoms can essentially be anything, even a myth. For
Frank, it is important to note that the explanation is not required to be “true”;
instead, he simply requires that it is acceptable and plausible. Finally, he
addresses the concept of “technique” and replaces it with “ritual.”
This use of the concept of “ritual” was prescient given that the research
evidence that techniques aren’t responsible for change was weak at the time
Frank developed his theory. It seems clear that he used the concept “ritual”
in part because he was developing a model broad enough to include shamanic
healing, but it was still an idea that was well ahead of its time. Finally, he
concludes his model by emphasizing the power of belief and expectations.
Modern common factor theorists have integrated the research results with
Frank’s model and become much more assertive in their use of the concepts
of myth and ritual. Their sense of “myth” includes two of its most common
definitions: something that isn’t true and something that provides a meaning-
ful foundation for experience and choices. In the following quote, Anderson,
Lunnen, and Ogles (2010) explain their understanding of myth and psycho-
therapeutic rationales.

To be persuasive, any intervention must first be meaningfully linked with shared

communal beliefs (Wampold, 2007). As Frank and Frank (1998) noted, “The
power of any therapeutic rationale to persuade is influenced by the culture from
which it derives. In devout cultures, religious rationales may have the greatest
therapeutic power. In our secular society, such power derives from science” (p.
590). In short, models must possess a rationale that strikes at the heart of what
it means to be a person within a particular place and time. (Kindle Locations
3909–3915)

Like constructionists, Anderson et al. are relatively unconcerned about the

literal truthfulness of the explanation; as long as it is meaningfully linked to
communal beliefs, it will work. This is a radical break from standard clinical
psychology where the explanations offered to the client are seen as truthful
and accurate. In the common factors model clinicians are enjoined to adjust
their own beliefs to the worldview of the client. In addition, if the clinician
determines that the client shares a prevailing mythic belief—for example,
that anxiety or depression has roots in childhood trauma—then they are free
to expand the client’s investment in that worldview by exploring it in depth.
There are few limits on what can serve as an explanation. Clearly the farther
outside prevailing beliefs, the more work the therapist needs to do to support
the mythic explanation.
The next major aspect of the common factors theory is the procedure or
ritual. The research has made a significant contribution in that it has virtu-
ally made it impossible for thoughtful research consumers to tout the ben-
efit of techniques and “specific factors.” Recall that Wampold took an even
124 Chapter 5

more radical stance and argued that the issue of the power of techniques is
such a dead end that “clinical trials comparing two treatments should be
discontinued.”
On the surface, this appears to be a radical idea: cease all research into
new techniques and abandon the hope that the next procedure will be more
effective. The fact that virtually everything works steals the sense of perma-
nence and solidity from techniques. Of course, client suffering remains real
but the explanation for the suffering is a construct and the ritual/procedure
is a construct. Constructionists understand that the power to change is never
in the technique; it always exists in the presentation of the therapist and the
endorsement of the client. Once again, the client is not changing because a
powerful technique has been employed that correctly fits the specific diagnos-
tic problem; rather, any procedure that is invested with meaning will serve as
a change agent. Anderson et al. comment:

Ritual or technique is the means by which a given cultural myth or therapeutic

rationale is enacted. Where myth or rationale explains why, ritual or technique
shows how. In the field of psychotherapy, practice and research have long been
dominated by therapeutic technique. At the same time, it may be said, para-
phrasing Winston Churchill, that never has a subject that contributes so little to
outcome received so much professional attention and approbation. As reviewed
elsewhere in this volume, no differences in effectiveness have been found
among treatment approaches intended to be therapeutic. . . . In other words,
therapeutic techniques are placebo delivery devices (Kirsch, 2005). . . . At this
point, suffice it to say that techniques work, in large part, if not completely,
through the activation and operation of placebo, hope, and expectancy. (2010,
Kindle Locations 3948–3960)

This is a wildly constructionistic view of psychotherapy. It doesn’t matter

what is done as long as it is accepted by client and therapist and both believe
that the ritual will lead to change or improvement. Virtually everything works
as long as it is done with the right attitude. In sum, selecting the correct pro-
cedure is not the secret; rather it is imbuing the procedure with numinosity.
While these arguments about ritual are well supported by both the research
results and logic, they do run into the problem that arises with all construc-
tionist explanations: how can a therapist authentically support a ritual with
the same allegiance that they would have with a technique? This is particu-
larly important given that the research has shown—not surprisingly—that
therapists get better outcomes when they believe in the approach that they are
using. In the following quote, Anderson et al. directly address this question
and argue that they can achieve this faith and inspiration by aligning with the
client’s “narrative truth” and by abiding with their own “core beliefs.”
 The Nomological Net 125

Awareness that contemporary healing practices are infused with the culture’s
mythology does not necessarily diminish one’s ability to participate in and
use them in treatment . . . (j)ust because a therapist might have an awareness
of treatment as myth does not reduce the therapist into a detached and cynical
critic who is playing a charade. As noted throughout, effective therapy requires
emotional investment and commitment to some shared cultural values. That
is, the therapist who cannot summon a passionate commitment to his or her
core beliefs will ultimately fail to engage the patient in an emotionally charged
relationship. The therapist’s own emotion and commitment serve to weave treat-
ment myth, treatment principles, and ritual into a powerful and persuasive com-
munication that, in turn, enhances the therapeutic relationship. . . . Knowledge
that these values are culturally dependent need not be a forbidden fruit that bans
the therapist from participation in his or her own culture, nor from conducting
good psychotherapy! For many therapists, adherence to their practices seems to
be based on both literal and historical sense. Therapists may believe just as stri-
dently that only the client’s narrative construction is true in its own right. With
regard to the latter, narrative truth is no less real than the physical and historical
reality, such as in the prior discussion of placebo effects. (2010, Kindle Loca-
tions 4157–4176)

This answer returns us to the end of the chapter on constructionism and

directly raises the question of the need for a “place to stand.” For example,
when psychology is framed as a discipline that operates in fundamental real-
ity—and, hence, has techniques—the question of meaning and belief are
secondary. If I know a technique that has the power to reduce your anxiety or
relieve your depression, then it is ethical for me to share it with you and easy
for you and me to believe in it.
Conversely, the moment I operate in a “technique-free” zone—in con-
structed reality—huge problems arise in the area of meaning and belief.
Anderson et al. point us in the right direction with their references above
to “core beliefs” and the “client’s narrative truth.” Fortunately, Tillich has
already taken us further down that road when he references the client’s
“ultimate concern.” Standing with Tillich, the constructionist therapist can
argue that a given ritual is meaningful because it participates in advancing
the client’s evolutionary path—the hierarchical aspect of Tillich’s model.
For example, when a constructionist therapist tells a client that the way to
get over her rape-related PTSD is to help other survivors, this frame can be
advanced with full sincerity. The knowledge that the therapist might have
said instead, “The best way to release your anxiety is to go on a Buddhist
meditation retreat and experience that your ‘true self’ was always untouched
by the rape,” fails to diminish the therapist’s authenticity or their commitment
to the injunction.
126 Chapter 5

Finally, it is worth examining Frank’s understanding of the therapeutic

relationship. He notes that the therapy requires “a healing setting.” The heal-
ing setting literally refers to an office or hospital, but in a larger sense, it also
refers to a license, an education, and a title like “doctor” or “life coach.” In
discussing the healing setting Frank is endorsing the concept of the implicit
hierarchy between the therapist and the client. I come to the healing setting
because that’s where the magic happens. The therapist is a denizen of the
magic or sacred space and, hence, implicitly has great powers.
But, of course, these are only outer symbols; the real sense of respect is
derived from the projected confidence of the therapist and the ability of the
therapist to explain the dilemma both clearly and in a manner that pushes
the conceptualization of the client into a new dimension. In so doing, the
therapist demonstrates greater consciousness than the client; in so doing, they
appear “charismatic.”
Frank’s model helps differentiate the therapeutic relationship from normal
relationships. I can have a relationship with a wise and caring friend, and
their counsel can be helpful to me, but our relationship lacks hierarchy—they
are not my superior. Conversely, in a therapeutic setting I have a relationship
with a wise and caring therapist who, by definition, is one up on me. Whether
techniques have inherent power or not, when I go to a therapist for healing—
and visit her in a healing setting—I assume that she will have something
special to offer me. And without that specialness both the explanation for my
problem and the prescribed ritual will fall flat. Understanding that hierarchy
is necessary in order to achieve good outcomes is central; when knowledge of
techniques does not confer implicit respect, the therapist must pay attention to
their own charisma. Put another way, the therapist is special because of who
she is, not what she knows.

THE NEW THERAPEUTIC MILIEU

One must still have chaos in oneself to be able to give birth to a

dancing star.
—Friedrich Nietzsche, Thus Spake Zarathustra (1896)

With this chapter, we conclude the description of Reality B: the new thera-
peutic milieu. Our journey began with the therapy outcome research results.
The findings that beginners are as effective as experts and the lack of innate
power in techniques indicates that therapy operates outside of conventional
assumptions about reality. The huge denial—Maher’s “Bubble”—about the
import of these findings was addressed by Kahneman’s work with System 1.
He argues that it is characteristic of the most powerful part of the mind to
 The Nomological Net 127

create worldviews that are oversimplified and inaccurate in order to impose

apparent order on the terrifyingly chaotic world. He also pointed out that
these inaccurate worldviews are vigorously justified and defended using Sys-
tem 2—the rational and analytic part of the mind.
This “terrifying chaotic world” has three major components: Buddha’s “old
age, sickness, and death”; the shifting, insubstantial, and ephemeral nature of
the Self; and the implicit sense that the values, beliefs, and vision of reality
espoused by one’s “home culture” are constructed and made up. Collectively
these three form the Abyss—the place of chaos, terror, and meaninglessness.
Its presence is obvious and apparent; we all feel like we are one small slip—
in our health, fortunes, or luck—away from disaster and defeat. In order to
co-exist with the ever present terror, most humans cultivate some form of
denial. For many of us, this denial works fairly well, but all of our actions,
choices, and feelings continue to be in dialog with the underlying Abyss.
Constructionism is as old as thought. It is the inevitable result of any kind
of self-reflection and is present in one form or another in every culture. Con-
structionism is a core component of the “perennial philosophy,” an essential
and inevitable critique of facile assumptions about reality. Apollonian forces
always resist constructionism, understanding its implicit and explicit threat to
the social order and to healthy denial.
The concept of constructed reality is always in dialog with its partner,
fundamental reality. Regardless of the arguments of philosophers, the human
experience rests in the sense that we live in a shared world that is actually
real. This world of “trees and houses” stands in contrast to the constructed
world of concepts like “masculinity and honor.” Higher order discernment
separates the one reality from the other.
Mild constructionism does not require an encounter with the Abyss. To
understand that feminine beauty is relative and culturally determined is an
insight that cuts through certain levels of social programming but it does not
shatter one’s sense of reality. In contrast, constructionism taken to its logical
extreme always leads to the edge of the Abyss and leaves the seeker exposed
to meaninglessness and anomia. Psychotherapists who develop a powerful
relationship with the concepts of the ephemerality of the Self and cultural
relativity will arrive at this edge.
Genuine seekers eventually have need of a “Place to Stand”; members of
a helping profession, who require a sense of meaning and purpose to guide
clients in distress, are particularly dependent on finding a center. Tillich tells
us that all such places to stand—his model, and other spiritual/philosophi-
cal models—share two key components: faith—where faith is defined as a
relationship to an ultimate concern—and doubt. Humans are impelled into
relationship with an ultimate concern by their essential nature. If Tillich had
lived to read Kahneman, he might argue that System 1 is not only required
128 Chapter 5

to create worldviews but those worldviews have a central connection to an

ultimate concern.
The worldview is not simply an individual matter; it is interwoven with
all significant others and also tied in with cultural assumptions. This inter-
weaving defines the Nomological Net. It is the job of all Apollonian forces
to defend the current structure of the Net and only allow permissible evolu-
tion—such as a child becoming an adult—and resist more radical alterations.
Since psychotherapists are agents of change, the profession is implicitly Dio-
nysian and is essentially provocative and revolutionary. That said, Apollonian
forces are always seeking to coopt the Dionysian and it is clear that there are
a great many Apollonian forces operative in psychology itself.
Finally, Frank’s common factors theory—especially the more provoca-
tive, modern version of it—defines therapeutic growth as a process which
begins with a mythic explanation and creates change through rituals. Without
the shelter of active and innately powerful techniques—or the privileged
knowledge which defines most professions—enhanced therapeutic efficacy
rests on therapist charisma—the ability of the client to see the therapist as
a key figure with the power to define the rules of constructed reality. The
essence of change is not dependent on what the therapist knows but on who
the therapist is.
All the theoretical factors are now in place: the research results, Kahne-
man’s System 1 and its need to create worldviews, the terrifying Abyss with
the implicit need for denial, pragmatic constructionism with its attendant
fundamental reality and constructed reality, Tillich’s “place to stand,” the
Nomological Net, and the therapeutic environment espoused by common fac-
tors theory. These factors show the path from Reality A to Reality B.
More specifically, they define the new therapeutic milieu. Its geography
now has shape and form. Its implicit rules and principles govern the pos-
sibility of therapeutic change. This has meaningful implications for how
therapists can be trained and for how they can improve over their professional
lifespan; in sum, it outlines a path that leads to enhancing therapist efficacy.

NOTE

1. Obviously social justice plays a large role in becoming a liminal member. There
are no completely “just” societies; hence there will always be individuals and groups
that are liminal members secondary to injustice.
 Part II

ENHANCING THERAPIST
EFFECTIVENESS

The strongest and sweetest songs yet remain to be sung.

—Walt Whitman, “November Boughs. A Backward Glance O’er
Travel’d Roads,” 1888

129
 Chapter 6

Focus on the Therapist

I am larger, better than I thought; I did not know I held so much

goodness.
—Walt Whitman, Selections from the Prose
and Poetry of Walt Whitman (1898)

Now that we have a shared sense of what “water” is, we can move directly
to the primary concept of the book: enhancing therapist effectiveness.
The central focus of these enhancement strategies will be the very arena
that the research discounts: therapist experience. We all feel powerfully
affected—indeed, sometimes, transformed—by our encounters with our
clients and their lives. Regardless of how convincing the research results
may be, accepting the conclusion that my clinical experience fails to make
me more effective remains unsettling. In this sense, it is entirely appro-
priate to make experiences in the room the key contributor to enhancing
therapist efficacy.
While many, many books have been written extoling the privilege of
working with clients, the power of the experiences in the room, and the
transformative impact on the therapist, these same books labor at a sig-
nificant disadvantage. Most of these books implicitly or explicitly endorse
scientific psychology and its pursuit of powerful techniques and replicability.
Privileged knowledge necessarily diminishes the specialness of the therapist;
when one has techniques that have independent power, the individual thera-
pist is simply a technician. In this sense, scientific psychology is always the
enemy of directly cultivating therapist charisma.
Being effective in constructed reality requires a shift from this outer focus
on privileged knowledge and technical mastery to an inner focus on qualities
that mark the therapist as a gifted and special individual. Duncan, Miller,
131
132 Chapter 6

Wampold, and Hubble (2010) comment on the centrality of the inner quali-
ties of the therapist:

For one thing, this volume brings the psychotherapist back into focus as a key
determinant of ultimate treatment outcome—far more important than what the
therapist is doing is who the therapist is. (Kindle Locations 385–386)

Once it is acceptable to change the focus of the search from techniques to cul-
tivating therapist charisma, a new range of possibilities arises. Traditionally,
when psychology looks at what occurs in the room, the focus is on how the
techniques impact the client. What if the focus shifts to how the experiences
in the room facilitate or diminish therapist charisma?
This may seem unethical; after all, the entire purpose of being in the room is to
serve the client’s needs. But when we are focusing on being more effective, the
actual emphasis should be on how the time in the room enhances the therapist.
And, of course, an enhanced therapist is more capable of serving client needs.
Once we give ourselves permission to make such a shift, the strategy is fairly
straightforward: therapists need to see their time in the room as a “practice” that
leads to their own empowerment. At the same time, they must continue to be com-
mitted to the ethical concept that therapy is all about serving the client’s needs.
Putting these two seemingly incongruent concepts together is simpler than
it might appear. Take the example of Mother Teresa working with the poor
in Calcutta. There are dual levels of reality present in her actions regarding
“helping the poor.” One the one hand, Mother Teresa was attempting to
develop programs and interventions that would assist needy individuals. On
the other hand, she was aware that she was performing her good deeds in
order to purify her heart and to serve her God. In that sense, she was helping
poor people in one reality and cleansing her own ego in another reality. Her
work was focused on helping others but was simultaneously a spiritual prac-
tice oriented toward her own evolution.
These dual levels of reality are fairly common and typically occur when a
set of outer activities that achieves one goal simultaneously results in inner
activities that achieve a different goal. Perhaps the most famous example of
this is meditation. The external results are tranquility, lower blood pressure
and stress reduction. In the right context, the inner results can be a sense of
existential peace, bliss, and enlightenment. The Christian psychologist works
with clients and simultaneously follows the will of God. The Buddhist psy-
chologist works with clients and attempts to experience “no Self.”
The focus on how the time in the room either facilitates or diminishes
charisma requires a brief definition of charisma. As used herein, charisma
refers to the ability of the client to perceive the therapist as a key individual
who has the authority to define reality. Recall that constructed reality is
 Focus on the Therapist 133

held together by the Nomological Net, a structure which varies from cul-
ture to culture. Every culture has key individuals who are “empowered”
to define the nature of reality—the Net—for the individuals in the culture.
Examples are parents, teachers, mentors, and leaders. A therapist must
aspire to be perceived as such an individual if they are going to be a supe-
rior clinician.
There are two primary factors which characterize charisma. The first is
wisdom—the ability to discern what is fundamental from what is constructed.
The second is compassion—the “I-Thou” relationship formed at the edge of
the Abyss. This “pursuit of charisma” may seem egocentric especially in con-
trast with the selfless approaches of Mother Teresa or the Buddhist psycholo-
gists discussed above. This is particularly true because the common usage of
charisma often confuses the concept with the kind of narcissistic behaviors
found in the wealthy, the famous, and the powerful. In contrast, however,
therapeutic charisma tends to be humble and self-effacing without losing the
ability to be direct and confrontive when appropriate.
This second half of the book is characterized by multiple clinical vignettes
and examples. The vignettes in the clinical section may appear familiar; they
may look like concrete examples that illustrate the application of certain
techniques. This appearance is likely to be amplified by the fact that many
of the vignettes are taken from other books which teach techniques. In truth,
however, they have been chosen because practicing these approaches with
the correct consciousness can lead to enhanced therapist charisma. We should
remember that anyone can copy a shamanic technique; it is both rarer and
more useful to use the technique to awaken one’s inner shaman.
The clinical examples have another purpose; they offer concrete examples
of the differences between Reality A and Reality B. Examine the following
quote from Stephen Lawhead (1988).

Perhaps it is how we are made; perhaps words of truth reach us best through the
heart, and stories and songs are the language of the heart. (p. 164)

As is well known, stories often convey the essence of an idea better than
abstract reasoning. Most of us will be able to get a better feel for constructed
reality through stories and narratives versus expository writing. The Abyss is
also better understood through concrete examples, particularly its paradoxical
nature of being simultaneously chaotic and terrifying and numinous and orac-
ular. This is not a minor point; reviewing multiple vignettes is probably the
only way to get a sense of where the fundamental stops and the constructed
begins. Moreover, seeing therapeutic results as a product of myth and ritual
instead of techniques and privileged knowledge also requires concreteness,
practice, and repetition.
134 Chapter 6

PRAGMATICS

He who would learn to fly one day must first learn to walk and run
and climb and dance; one cannot fly into flying.
—Friedrich Nietzsche, Beyond Good and Evil (1886)

What needs to change so that the daily practice of psychotherapy becomes

transformative? Every therapy experience that makes a therapist into a bigger
person—one with more charisma—has the potential to be transformative. We
all have moments with clients where we encounter fear and move through
it, or have profound heartfelt connections, or deep epiphanies. Having the
average amount of such moments makes one an average therapist. Our focus
needs to be on having above-average amounts if we wish to be superior
therapists.
Simply being a seeker of such experiences creates an immediate positive
result. When I believe that a technique changes the client, then I seek to be
a master of powerful techniques. When I believe that my charisma is the
definitive factor, then I seek charisma. With few exceptions, workshops and
trainings teach us that the power is in the client or in the technique. Replacing
that focus with an intention to use every opportunity in therapy to enhance
charisma makes an enormous difference.
The second key factor that allows the psychotherapy experience to gener-
ate charisma is the attempt to master the dialog and the interfaces between
therapy and constructed reality. This book has repeatedly argued that it is
difficult to grasp the effects and power of constructed reality in our lives.
We are programmed to act as if everything occurs in fundamental reality.
Passing through the exact same therapeutic interactions—but experiencing
and understanding them from a constructed reality perspective—is transfor-
mative. For example, the work of therapeutic wizards has frequently been
studied with the hope of distilling their techniques; we expect that copying
their techniques will allow us to replicate their results. Unfortunately, as we
have discovered, this approach—which would work well in fundamental
reality—fails time and again in the psychotherapeutic world. Studying Mil-
ton Erickson has not resulted in a thousand students replicating Erickson’s
results. Perhaps these disappointing outcomes occurred because his actual
results were simply due to Ericson’s charisma; as a key individual he simply
needed to ask for a client behavior to achieve change. We have been dis-
tracted by what he did and missed who he was. Focusing on what actually
works enhances charisma.
A second example comes out of Frank’s common factors model. What if
a therapist actually perceived every explanation for the client’s problem as
a cultural or individual “myth” and every intervention as a co-created and
 Focus on the Therapist 135

co-endorsed “ritual”? What kind of freedom and flexibility arise out of those
understandings and how might that enhance a therapist’s charisma?
These two factors—directly and deliberately seeking charisma and expe-
riencing all therapeutic interactions in the context of constructed, as opposed
to fundamental, reality—are the central strategies underlying the approach of
this book. But we can make it even more specific. A map or geography of
constructed reality can be developed using the principles articulated in the
first half of the book. The two primary features of this map of constructed
reality are the Nomological Net and the Abyss. The two have an ongoing
dialog with each other. The Net gives form and stability to human culture
and individual identity. The Abyss—with its implicit chaos and meaningless-
ness—attempts to break through the shelter of the Net. The Apollonian forces
attempt to support the Net and resist the Abyss while the Dionysian forces of
the Abyss threaten with terror and alienation but also beckon with creativity
and spontaneity.
Psychotherapeutic systems can be described in terms of their position in
the Net-Abyss dialog. For example, they can emphasize the Net aspect of
constructed reality in which case they will prioritize success in the world,
controlling emotions, and fulfilling expectations. Apollonian therapies such
as CBT and reality therapy are examples of such systems.
The Abyss, of course, is always attempting to break through the shelter of
the Net; these breakthroughs manifest externally as death, aging, and illness
and internally as symptoms and pathologizing. Depth psychology and affec-
tive therapies focus on such breakthroughs; ultimately they work with the
concept that this “shadow material” contains hidden meanings and guidance.
Where the Net stops—the edge of the Abyss—is the provenance of altered
states. Hypnosis, group therapies, and retreats operate in this domain. Finally
some individuals attempt to “leap into” the Abyss in search of the numinous
and the oracular. This is the purview of the transpersonal therapies and the
spiritual traditions.
In sum, an individual’s place in constructed reality can be defined by her
proximity to the Net or the Abyss and the nature of the interaction with these
two forces. Similarly, the major schools of psychotherapy can also be defined
by their place in constructed reality and by their relationships to the Abyss
and the Net. One can frame participation in the different schools of therapy
as an evolutionary experience where the therapist and her clients move from
a more Net-centered focus to a more Abyss-centered one.
Traditional psychotherapy recommends either a focus on one school of
therapy—mastering it on a deep level—or a kind of self-selected eclecticism.
However, if the point of doing therapy is to enhance charisma, it is more use-
ful to accept the challenge of every aspect of the Net-Abyss dialog; in short,
there is benefit in mastering the essence of every system. For most therapists,
136 Chapter 6

one part of the Net-Abyss dialog will be more comfortable and other parts
more challenging. Accepting challenges generates charisma. Forcing oneself
to operate out of one’s comfort zone—concentrating on the area where one
is weakest—is called the deliberate practice model. Mastering one’s weak-
nesses enhances charisma.
Similarly, pushing further up the evolutionary chain than one might find
comfortable is also helpful in terms of charisma enhancement; having a sense
that there is no part of constructed reality that is “off-limits” generates the
kind of charisma associated with any explorer of distant worlds.
Each chapter in the clinical section has been chosen to illuminate one facet
of constructed reality or another. Not surprisingly, the first clinical chapter is
concerned with differentiating between fundamental reality and constructed
reality. The second chapter—on therapeutic wizards—defines the goal of the
book; it discusses the power and effectiveness of the archetypal charismatic
therapist. Following are chapters on Apollonian therapies, the fluidity of the
Self, and breakthroughs of the Abyss. Constructionism places a high value
on the contributions of the client—after all, the client creates his own reality
as much as the therapist does—so there is a section on going beyond client-
centered therapy and working with the ultimate concern. Finally, as the indi-
vidual elects to have a more direct experience of the Abyss, there are chapters
on altered states and Dionysian therapies. Moving from the Net-centered
therapies to the Abyss-centered therapies is called the evolutionary model.
The third model, Mindful Development, is both the most obvious and yet,
in some sense, the most challenging. Psychology has a long tradition of rec-
ommending personal growth for both beginning and experienced therapists;
if I can resolve my own issues and cultivate depth and an internal richness,
I ought to be a more effective therapist. Generally this has taken the form of
participation in personal therapy as part of a psychotherapy training program.
While it is logical to expect that therapists who have had more personal
therapy will be superior to less exposed therapists, the research on this ques-
tion has failed to find support for this supposition (Macran & Shapiro, 1998).
In short, personal psychotherapy fails to enhance charisma.
This inability of simple personal growth experiences to enhance charisma
should not be discouraging; rather it suggests that only the most powerful life
events will be helpful. The Mindful Development practice focuses on iden-
tifying such events and utilizing them consciously in service of becoming a
more effective therapist.
The fourth approach to enhancing therapist charisma is called dancing with
the Abyss and has some similarities to an intentional mindfulness practice.
The essence of this approach is to be as aware as possible of the nature of
reality, of the dialog between the Net and the Abyss, and of the presence of
meaning in the form of the ultimate concern.
 Focus on the Therapist 137

There is always a dynamic tension between Apollonian and Dionysian.

Almost every approach outlined in the clinical section can be performed
from an Apollonian stance or a Dionysian one. One intervention can leave
the Net intact and create incremental and predictable change or, conversely,
it can generate altered states, be discontinuous, and create experiences of
“being a different person,” “living in a new reality,” and “waking up from a
sleep.” Feeling the presence of the Net and the Abyss as one crafts and car-
ries through interventions changes the therapist as well as the client. Holding
a sense of being outside the Net and connected to the Abyss opens doors to
enhancing clinical outcomes.
There is another dance that is also central: the dialog between the ultimate
concern of the client and the ultimate concern of the therapist. At the end of
the day, all charisma flows from the ultimate concern and every ritual is a co-
creation between the therapist/client and their ultimate concerns. Cultivating
charisma can often sound like an ego-centered activity. Realizing that it is
centered in the ultimate concern addresses that issue. The research demon-
strates that client factors are much more important in predicting outcome than
therapist factors. Recognizing this means that at the end of the day, serving
the client’s ultimate concern is always the priority.
Clearly the Net and the Abyss are always in dialog with each other. The
Net is paradoxically supportive yet constraining; the Abyss is terrifying yet
numinous and oracular. Feeling all of these forces moving together is the
essence of the dancing with the Abyss model.
Finally, a note of caution: once one accepts the implications of Reality B,
the recommendations and observations contained in the following clinical
chapters are fairly straightforward. However, fulfilling these recommenda-
tions requires sustaining a sense of the fluidity of reality. This puts one in
direct conflict with Kahneman’s System 1 and its power to reify reality into
a safe worldview. Recall that Kahneman called System 1 the “hero” of his
book and documented numerous examples of his own and others’ difficulties
surmounting its power to confuse and confound. Eastern religions go on and
on about the power of Maya—illusion—to seduce and trap even the most
prepared. Staying awake—not going back to sleep—is a major challenge.
Rumi comments:

Sit, be still, and listen,

because you’re drunk
and we’re at
the edge of the roof.
 Chapter 7

Beginner’s Mind

What has been is what will be,

And what has been done is what will be done,
And there is nothing new under the sun.
—Ecclesiastes 1:9

The Reality B model implies that the therapist must work to loosen, lighten,
remove, and realign the threads of the Nomological Net which currently
define the identity of a client who is experiencing suffering and dysphoria.
This suggests that the therapist must be capable of seeing the client’s iden-
tity as fluid, changeable, malleable, and plastic. Naturally the client will not
be much help here. If the client could see himself as a person with many
resources and options—a person capable of adapting to changing situations―
it is unlikely that he will present for therapy.
In terms of fluidity and adaptability, most of the extant psychological
systems tend to be as unhelpful as the client’s own self-image. The medi-
cal model, with its emphasis on psychiatric diagnosis and labeling, tends to
support the threads of the Net and add new threads, some of which are very
strong. Being labeled a depressive, a personality disorder, or learning dis-
abled is not likely to help the client or the therapist see him as fluid, change-
able, or full of options. Similarly being seen as prone to irrational cognitions
or an alcoholic or an incest survivor rarely makes one more mobile. In sum,
labeling virtually always works to stabilize the client in the current position.
Moreover, as Burger and Luckmann point out, therapists who work with
“deviants” all day, every day, have their own sense of vulnerability to the
Abyss and their own need to apply labels to clients which help mark them as
different and “not like me.” Obviously a label or diagnosis makes the indi-
vidual into an object as opposed to a person; the object’s doubts, feelings,
139
140 Chapter 7

and confusions now belong to someone “broken” or “different” and are less
likely to infect or spoil me. The first step toward understanding and working
with a constructionist approach is to sense all of the forces—within the cli-
ent certainly—but also from the culture, the profession and, of course, from
inside the therapist―which act to stabilize the client’s identity.
If one takes the research seriously, and fully accepts that our well-
developed psychological systems are not useful maps in terms of increasing
therapeutic effectiveness, then it is clear that generally accepted concepts
such as the trauma of childhood experiences, irrational thinking, and diag-
nostic categories are not helpful when framing cases and developing inter-
ventions. Instead of using these systems, as each client enters the office, the
psychologist needs to be free to perceive him through whatever perspective
she finds most appropriate at the moment. This freedom can be empowering
in that one no longer has to see people though the AA lens of “alcoholic/
addicts” or the psychodynamic lens of “narcissism,” yet it can also be confus-
ing or even terrifying to try and operate without the ability to lean on gener-
ally accepted psychiatric concepts.
One of the most powerful explorations of this concept of seeing people and
situations without preconceptions comes from Shunryu Suzuki’s book, Zen
Mind, Beginner’s Mind, where he states: “In the beginner’s mind there are
many possibilities, but in the expert’s there are few” (2010, p. 1). Suzuki’s
statement arises directly out of the Zen practice of meditation. In this practice,
every event, feeling, and cognition is to be experienced as it exists, without
judgment, prejudice, or reference. Each experience is whole in itself and
complete in the present moment. There is no cataloging and there are no
typologies that summarize data. Each experience is fresh, unique, and unlike
any other. The ability to operate from this perspective is what he calls “begin-
ner’s mind.”
He contrasts this with “expert mind” which interprets every experience in
the context of a limited number of preconceived categories. Being restricted
to a few options in predefined categories limits the therapist’s creativity and
her ability to see the client as unfettered. In psychotherapy—which operates
in constructed reality—loss of options is virtually always counterproductive.
Contrast that with expert mind operating in fundamental reality. Funda-
mental reality is relatively predictable and solid. Eliminating options that
don’t work or work poorly simply makes one more efficient and effective.
In such cases, expert mind generates reliable and superior results. Unfortu-
nately, much as we may wish otherwise, psychotherapy—and constructed
reality―operate outside the purview of expert mind.
More specifically, every extant psychological system is a form of expert
mind. These systems force the practitioner into seeing the client as the
victim of a pathological family system, or traumatized, or unable to think
 Beginner’s Mind 141

“rationally.” In the midst of the presuppositions created by the various sys-

tems, the uniqueness of the present moment is lost. It is helpful to let these
assumptions go. And the research that the systems do not add value in terms
of therapist effectiveness reassures us that discarding their theories will not
be harmful.
The good news is that this concept of beginner’s mind has been present in
Western culture for almost half a century and is more or less woven into our
shared reality. Ever since Ram Dass wrote Be Here Now, and Eckhart Tolle
extended the concept with The Power of Now, much of Western culture has
been infused with the idea that the wise and healthy person is the one who can
be truly present, truly “show up.” This concept has never been that hard for
people to understand because the vast majority of people have at least some
experiences where they are actually present, without self-consciousness, and
only paying attention to what is occurring in that moment. Examples of this
sort of consciousness are easily found: the basketball player who is making a
move for the basket, the musician who is immersed in the song, the scientist
who becomes one with his theory, and, yes, the therapist who is fully paying
attention to the client in front of her. In Reality B language, at these moments,
the person is temporarily unconcerned with the threads that stabilize his iden-
tity—he is not self-conscious―and simply operates as the situation requires
in the context of the present moment. For the athlete, the game is the context;
for the musician it is the song, and so forth.
Tara Brach (2012), a Buddhist therapist, uses the term “mindfulness” to
describe this same process.

In the simplest terms, mindfulness is the intentional process of paying attention,

without judgment, to the unfolding of moment-to-moment experience. It is the
opposite of trance, a word I use to describe all the ways in which we—therapists
and clients alike—live inside a limiting story about life. (p. 37)

In this short quote, Brach pulls together the Reality B perspective in a few
simple lines. Strive to be present and mindful. There are forces around the
therapist and within the therapist which will distract and confuse one—forces
which act to put the therapist in an impotent trance, forces which are limit-
ing. These forces need to be recognized and the therapist needs a practice to
minimize their influence.
The first step toward becoming a Reality B therapist is to differentiate
constructed reality from fundamental reality. Operating in constructed reality
requires mindfulness and beginner’s mind—the ability to show up in each
moment without preconceptions. This enhances creativity and facilitates
relationship; the client feels seen and is allowed to freely change and grow
without preconceived and predefined limitations. While it takes an act of
142 Chapter 7

discernment and courage to release expert mind—to release the standard

psychological worldview―the results of the outcome research and the con-
structionist analyses support the leap from Reality A to Reality B.

DIAGNOSES AND PRECONCEPTIONS

No one is sane, straight along, year in and year out, and we all know
it. Our insanities are of varying sorts, and express themselves in
varying forms—fortunately harmless forms as a rule.
—Mark Twain, Mark Twain’s Letters (1917)

Nothing interferes with mindfulness quite as effectively as labeling and diag-

nosis. Formal categorizing pushes us into expert mind with all of its implicit
assumptions about pathology, prognosis, dynamics, and associations to past
clients with the same diagnosis. And this is not limited to the therapist; most
clients come to therapy with either a formal diagnosis from a mental health
professional, a diagnosis bestowed by family, friends or self, or a set of codi-
fied assumptions that might as well be a diagnosis. For example, the client
may say: “I’m anxious because everyone in my family is anxious,” or “my
psychiatrist told me I have a biochemical imbalance and I will need to take
medications for the rest of my life to be normal,” or “I’m the black sheep in
my family and, because of that, I have a fear of success.”
As a general rule the therapist should make every effort to keep the cli-
ent’s identity fluid and malleable and resist these kinds of explanations and
interpretations, at least inside her own mind. Naturally, it is rarely helpful to
confront the client and point out that these explanations create more harm
than good. Instead, as Brach advises, they should be regarded as a kind
of hypnotic induction where the client, the culture, and the profession are
attempting to ensorcel the therapist to the point where they cannot imagine
the client as having another identity. A chronic depressive has little chance of
long-term change and a recovering abuse victim has little opportunity for real
independence. A clinical example will illustrate the point.1

A 15-year-old, high school freshman was referred to me for treatment of

anorexia. Six months prior she had been hospitalized for several weeks when
her weight had dropped down to 74 pounds. Post discharge, the parents had
set up a team of a therapist, a nutritionist, a psychiatrist, and a medical doctor
to treat her disorder. My initial interview with the parents suggested that all
of these professionals were experienced with eating disorders, had conducted
themselves in a competent and professional manner, and had extended them-
selves to the young woman in terms of being generous with their time and had
 Beginner’s Mind 143

treated her in a friendly and kind manner. In sum, she had a good team and was
receiving top notch treatment for the anorexia.
The client had responded by repeatedly lying to her parents and all members
of the team. She had water-loaded prior to weigh-ins, sewn weights surrepti-
tiously into her clothes, been angry and aggressive with her parents whenever
they brought up her eating choices, exhibited significant anxiety around eating
high fat food, and in every way demonstrated resistance to treatment. She had
cursed at her mother, pushed her, and the parents had been forced to call the
police on several occasions to control the teen. She was sent to see me after tell-
ing her parents she couldn’t relate to the previous therapist although the nutrition-
ist, the psychiatrist, and the medical doctor were continuing to serve on the team.
In my first interview, I told the young woman that, while she clearly had an
eating disorder in the technical sense, and while her parents and the medical
doctor were obliged to check her weight and to keep her safe, it would be more
useful for her to understand her condition as resulting from a particular part of
her personality. Using some other information from the interview and her his-
tory, I suggested that she had an atypical eating disorder was caused and main-
tained by her great capacity for single-minded focus and a corresponding ability
to ignore everything except her intended goal. In this case, she had decided that
eating pure food was going to enhance her physical health and athletic prowess.
Her single minded focus resulted in ignoring other factors like the simple truth
that her diet was putting her health at risk.
I also told her that she had long felt that no one else really understood her and
mentioned that she was accustomed to making decisions on her own. She had a
long history of academic and athletic excellence and she had confused achieving
“pure health” with achieving her high end goals. In sum, I framed her eating dis-
order as a positive part of her personality that had gotten somewhat out of control.
She immediately warmed to this interpretation and told me that everyone else
had been talking about how serious it was to have an eating disorder and telling
her that she needed to accept that she was going to have to struggle with it for
years. Moreover, she had been informed that healing was going to take a great
deal of perseverance, work, and effort, and that she was going to be a “patient”
for a long time to come.
I responded that because her eating disorder was “atypical” and came from
the best part of her personality, it had a much better prognosis than normal eat-
ing disorders. If she wanted to try, she could show her parents and the team that
she could vanquish her eating disorder relatively quickly, using the same tools
and motivation which had led to her exceptional successes in the athletic and
academic realms.
She quickly began to gain weight, reported that her charge around eating food
with a high fat content was mostly gone, and her emotional blow ups with his
parents diminished markedly.

This case illustrates how easily certain clients can move when the thera-
pist can free himself from the internal blinders created by diagnoses and
144 Chapter 7

conventional treatment protocols. Clearly this young woman had a severe

eating disorder with a significant risk to her health, a strong aversion to cer-
tain classes of food, and marked emotional agitation manifested as aggression
toward her parents and lying to the team. The team was justified in diagnosing
the young woman with anorexia and such disorders usually do require years
of treatment. The severity of her presentation made it difficult to avoid seeing
the client as the embodiment of her pathology. This is the exact moment when
the therapist most needs to see the identity of the client as fluid and malleable.
There was special pressure on me from both the parents and some other
members of the treatment team because, of course, the young woman told
everyone that her new psychologist had informed her that she “didn’t have
an eating disorder.” The pressure from the culture and the profession to reify
the identity of the client is real and palpable. Operating from a constructionist
point of view, where frames are seen as useful/useless instead of true/false
is a radical approach to diagnosis and treatment; inevitably, it will create
resistance and backlash. The initial resistance may be experienced inside the
therapist but the atypical frames and interventions will often create resistance
from every direction imaginable. There really are cultural, professional, and
individual forces—Apollonian elements―that attempt to stabilize individual
identity. They continue to operate even when the identity is dysfunctional and
creates pain in the client and those around her. Clients, their significant oth-
ers, and involved professionals sincerely desire positive change but they feel
compelled to fight a new frame if it takes an unusual form, especially when it
is accompanied by an atypical, unsanctioned explanation.
This leads directly into the question of how real and accurate my explana-
tion was versus the standard explanation of the treatment team. Construction-
ists would argue that neither explanation was true. Obviously, in this case,
mine was more “useful” in that it had a positive impact in a relatively short
time. From a Reality B perspective, it was also more useful because it was
designed with fluidity of identity in mind. It was not “true” that her eating
disorder was a result of using the same strategies previously employed to
achieve academic success, but when I suggested the idea, the client was
happy to embrace it. In this new frame she was no longer sick; rather, she
was a goal-achieving idealist on a “pure food diet” who had gone a bit too far.
That was a problem she could understand, accept, and correct. Conversely,
she resented and resisted the frame of being a patient recovering from an eat-
ing disorder.
Naturally both the parents and the other professionals distrusted her quick
and fairly effortless improvement because they saw her as an eating dis-
order and “everyone knows” that progress with such disorders is slow and
has many reversals. The professionals had even more difficulties with her
improvements than the parents because, as experts, they “knew” that these
 Beginner’s Mind 145

improvements were false and ephemeral and that she would quickly relapse.
The more expert, the more they saw her eating disorder identity as stable and
resistant to change.
It was clear that the teen could not “stomach” the eating disorder explana-
tions that had been offered from various professionals. She wanted to see
herself as a winner who had been striving for something great. In Tillich’s
language, the “pure food” diet participated in her ultimate concern. She saw
herself as strong, brave, unconventional, and independent. Conversely, the
eating disorder frame saw her as deeply wounded, dependent on support and
counsel from others, and only capable of slow recovery. In that sense, the
teen experienced any possible alignment with the eating disorder model as
a step backward into childhood dependency and as a violation of her com-
mitment to her ultimate concern. Her resistance was noble, not pathological,
and she saw cooperation with and acceptance of the professional model as a
personal violation. She justified all her lying, aggression, and resistance from
this point of view.
When Tillich and ultimate concern are introduced, we leave the world
of pure constructionism and enter the Tillichian reality of idolatrous versus
true ultimate concerns. In this sense, whatever intervention moves the client
further along toward her own authentic ultimate concern is truer for her. Til-
lich might argue that my intervention was not only more “useful,” it was also
better aligned with her ultimate concern and, hence, more valid. Put more
concretely, doing anything that facilitated the teen’s independence and suc-
cess was aligned with her ultimate concern. In sum, while constructionism
allows almost any alternative frame that ensures client’s fluidity, Tillich’s
model sharply limits the choices. Beginner’s mind does not stand alone; it
always coexists with the concept of the ultimate concern.
Beginner’s mind is not simply a spiritual concept; a number of prominent
therapists have urged trainees to be cautious about having implicit assump-
tions about clients. For example, in the following quote Milton Ericson rec-
ommends seeing the client as the “thing in itself.”

I think we should all know that every individual is unique. . . . There are no
duplicates. In the 3 1/2 million years that man has lived on earth, I think I’m
quite safe in saying there are no duplicate fingerprints, no duplicate individuals.
Fraternal twins are very, very different in their fingerprints, their resistance to
disease, their psychological structure and personality.
And I do wish that Rogerian therapists, Gestalt therapists, transactional
analysts, group analysts, and all the other offspring of various theories would
recognize that not one of them really recognizes that psychotherapy for person
#1 is not psychotherapy for person #2. I treated many conditions, and I always
invent a new treatment in accord with the individual personality. I know that
when I take us out to dinner, I let the guests choose what to eat, because I don’t
146 Chapter 7

know what they like. I think people should dress the way they want to. I am very
certain that all of you know that I dress the way I want to. (Erickson laughs.) I
think that psychotherapy is an individual procedure. (Zeig, 1980, p. 104)

While the language is different, Erickson is obviously encouraging his

students to begin every encounter with a new client with beginner’s mind.
Again, in the mental health world, expert mind is all about diagnostic cat-
egories and expectations that tend to stabilize a client in their pathology. The
resulting set of standard treatments often slow down treatment progress. Such
treatments are implicitly oriented toward creating a stable and predictable
reality—a reality that only changes slowly, a reality that keeps both profes-
sionals and clients from feeling destabilized.

THE SEDUCTIVE NATURE OF TECHNIQUES

I was in a printing house in Hell, and saw the method in which

knowledge is transmitted from generation to generation.
—William Blake, The Marriage of Heaven and Hell (1790–1793)

Belief that techniques are contributing to client improvement is one of the

greatest threats to beginner’s mind. The research, of course, completely dis-
counts the inherent power of techniques. If they are responsible for change,
then the therapist who knows more of them, or is better trained in them, or has
practiced them more, should be superior. And, of course, the research reports
no differences between the technically savvy and the beginner.
Even with this understanding it is hard not to feel as if the power lies in
techniques; when I do CBT with a client and they get better, it feels like they
were helped by the technique. Not only do I feel it but the client also believes
it. They tell their friends and family members that CBT really worked for
them and recommend the technique to others with similar problems.
In addition, therapists like to have a variety of tools so that they can
try another approach if the first one doesn’t work. Therapists often say,
for example, that “family systems didn’t work with the client but hypno-
therapy was much more effective.” Such statements simply feel true. But, of
course, they aren’t.
In the following clinical example we examine an unusual technique that,
like standard talk therapy, appears to be responsible for client improvement.
Yet in this case, the technique is so unusual—so outside of normal lim-
its—that it is relatively easy to believe that another factor is responsible for
improvement besides the technique.
 Beginner’s Mind 147

Some years ago, I was introduced to a retired OB/GYN who had set up
his own private psychotherapy practice. His specialty was unusual in that he
used hypnosis to identify and exorcise malevolent spirits. Apparently he had
stumbled upon this model through working with many patients in hypnosis.
I had a number of friends, acquaintances, and clients tell me that they had
consulted him and they shared their outcomes with me.
Not surprisingly, some of these people were put off by his belief in spirit
possession. However a number of the people reported that in spite of their
skepticism, the experience had been extremely positive for them. Apparently
the doctor identified the presence of malevolent spirits by ideomotor signal-
ing; in other words, he put his clients into a hypnotic trance and then asked
the unconscious mind to involuntarily raise a finger if they were possessed.
Then, through continued use of the ideomotor signaling, the doctor would
help the client access the resources required to remove the spirit. The doctor
would confirm the removal with more ideomotor signaling and then predict
that things would be much better now that the entity was exorcized.
Subsequent to this process, the clients typically experienced feelings
of lightness and relief. They also reported a significant reduction in their
presenting symptoms. A few said they felt better than they had in years or
even “I feel like a whole new person.” Of course, others reported no positive
results and stated that the entire experience had made them uncomfortable.
The first thing that must be granted is that the physician achieved better
results, and achieved them more rapidly, than the average psychologist. How
many of us generate such powerful results in just one or two sessions? Setting
aside the problems of inducing clients to believe in the existence of malevo-
lent entities, the doctor’s effectiveness was certainly impressive.
Like many stories of rapid change, the first question is often: “Are the
changes durable?” Clearly the rapidity and the power of the changes are
worth respect, but are they sustainable? Given that the exorcized client will
tend to have a hard time getting social validation from friends and families,
the powerful changes will have more trouble sustaining themselves than
more conventional change strategies. My family is more likely to support my
beliefs that I am different after ten sessions of insight-oriented talk therapy
than they are likely to support my belief that I am different because a new
age healer told me I was Charlemagne in my last life. Unless of course I am
in a new age cult and all my friends believed that they were famous people
in their last lives.
What makes this exorcism discussion both interesting and confusing is
that it highlights the lack of clear boundaries between fundamental and
constructed reality. This is especially true because Apollonian forces con-
sistently blur the two together and then declare that there is no constructed
148 Chapter 7

reality—only fundamental reality. Irving Yalom, the renowned existential

therapist, addresses these issues in the quote below.

The superego, the id, the ego; the archetypes, the idealized and the actual selves,
the pride system; the self system and the dissociated system, the masculine pro-
test; parent, child, and adult ego states-none of these really exists. They are all
fictions, all psychological constructs created for semantic convenience, and they
justify their existence only by virtue of their explanatory power. . . .
Does this mean that psychotherapists abandon their attempts to make precise,
thoughtful interpretations? Not at all. Only that they recognize the purpose and
function of an interpretation. Some interpretations may be superior to others,
not because they are “deeper” but because they have more explanatory power,
are more credible, provide more mastery, and therefore better catalyze the will.
When I present this relativistic thesis to students, they respond with such ques-
tions as “Do you mean that an astrological explanation is also valid in psychother-
apy?” In spite of my own intellectual reservations, I have to respond affirmatively.
If an astrological or a shamanistic or a magical explanation enhances one’s sense
of mastery, and leads to inner, personal change, then it is valid (keeping in mind
the proviso that it must be consonant with one’s frame of reference). There is
much evidence from cross-cultural psychiatric research to support my position;
in most primitive cultures only the magical or the religious explanation is accept-
able, and hence valid and effective. (Yalom, 2008, Kindle Locations 4852–4867)

In this quote, Yalom emphasizes the fluid nature of the psychotherapeutic

world. It is fluid, of course, because it operates in constructed reality. Yalom
validates astrology in his quote and, by implication, he also validates the
exorcism therapy. Saying he validates it does not imply that he thinks exor-
cism or astrology are real from a fundamental reality perspective; he means
that they are real and valid because they have the capacity to alter a client’s
Net and personal identity. And they have the same capacity to alter the Net
as other constructs: id, ego, and so on. Exorcism is considered “unreal” in
the context of Western constructed reality, but it is real to the clients that go
through the procedure and they are as changed by the “unreal” procedure as
they are by a socially validated one like “childhood trauma.”
Essentially Yalom argues that spirit exorcism is as experientially true as
any standard psychotherapy technique. And he goes further; his explanation
allows us to understand that the clients are changing not because of the innate
power of an exorcism, or standard talk therapy, or astrology but because the
procedure “enhances one’s sense of mastery, and leads to inner, personal
change.” It is true because they experience it as true. The client has the final
say about what is real.
Entities are not real—at least not in Western culture. Therefore exorcism
cannot be a technique in the way the term is used in fundamental reality.
 Beginner’s Mind 149

In the exorcism we have an effective procedure—probably more effective

than standard talk therapy in terms of immediate change—that cannot be a
technique. If it works, and it is not a technique, than what can it be?
Previously we reviewed the common factors model proposed by Jerome
Frank. In that model, he substituted the concept of “ritual” in place of tech-
nique. He used ritual not only because it included the shamanic healings
common across so many cultures but also because he understood that modern
clients were changing for the same reasons. Techniques were not the active
ingredient; ritual was just as central to change in the psychologist’s office as
it was around the medicine man’s fire.
Ritual can be defined as “a series of outer experiences that create a shift
in inner reality.” The secret, of course, is that the therapist and the client
must have an implicit or explicit agreement that the passage through the
outer experiences will, in fact, cause the inner shift. Some of the differences
between technique and ritual are well illustrated by the marriage ceremony.
The goal of the marriage ceremony is clear: the couple is moving from an
identification as single people into their new identities as married people.
In the marriage ceremony, the details can be altered substantially and the
result is unaffected. For example, the ceremony is just as powerful regard-
less of what music is played and how the couple are dressed; moreover, the
ceremony is equally moving whether it is Jewish, or Christian, or secular.
Conversely when it comes to a technique like the right way to build a house,
there is only one way—with a few small variations—to get the corners square
and the walls vertical. In a technique, if you change the details significantly,
the outcome will fail.
In a marriage ritual, the result is amplified when there is social consensus
that the couple is “really married.” The audience meaningfully participates in
the effectiveness and power of the ritual. In building the house, the corners
are equally square whether one person sees it or a hundred people witness it.
Phillip Dick tells us: “Reality is that which, when you stop believing in it,
doesn’t go away” (Dick, 1996, p. 261). Obviously, he is referring to funda-
mental reality and techniques.
In terms of therapeutic rituals, Yalom and Frank tell us the minimum
requirements for success. A charismatic and caring therapist offers (or co-
creates) a frame that explains why the client is suffering and why moving
through a certain procedure will change the client in the desired direction.
The client must be receptive to this explanation and motivated enough to
undertake the procedure. Since this is constructed reality, the procedure
itself has no innate power; rather, it is invested with the power of change
by the intentions of the therapist and the client. And, when the client moves
through the procedure, their belief that it will change them becomes a self-
fulfilling prophesy and they are changed. As Yalom says, “then it is valid
150 Chapter 7

(keeping in mind the proviso that it must be consonant with one’s frame of
reference).”
Yalom calls all the psychological constructs “fictional”: “They are all
fictions, all psychological constructs created for semantic convenience, and
they justify their existence only by virtue of their explanatory power.” In
calling these fictional, Yalom is stating that these concepts are not true from
a fundamental reality perspective. But what about their truth in constructed
reality? From that perspective, how can a ritual be fictional? There are no
“fictional” marriage ceremonies; there are only moving and meaningful mar-
riage ceremonies and, sometimes, flat and insincere ceremonies. Rituals are
not judged as true or false; rather they are judged as meaningful or meaning-
less and effective change procedures or ineffective change procedures.
The success of the exorcism procedure also points toward the “placebo
effect.” A placebo, of course, is a powerless treatment or drug; it generates
an effect because the clients are led to believe that it actually is a powerful
treatment or drug. Placebo is easy to understand with sugar pills and drugs in
fundamental reality; however, things become more complex when it comes
to psychotherapy and constructed reality.
First of all, the concept of placebo only makes sense in fundamental real-
ity where there are “authentic” interventions and “faux” interventions. In
constructed reality there can be no placebo because there is no innate power
in techniques and no “faux” interventions. In constructed reality every change
of belief is “real.” This has led to problems with psychotherapy research. Fol-
lowing the medical model, some psychotherapy researchers have attempted
to compare new psychotherapeutic interventions with faux psychotherapy
interventions. The problem, of course, is that when the “faux” interventions
are sufficiently developed to be credible, they work as well as the experimen-
tal intervention. And when they are degraded enough to be inert interven-
tions, the experimental subjects are aware that they are faux interventions.
Placebo experiments in fundamental reality allow researchers to separate
out active or specific effects from belief/expectation effects. The interest-
ing aspect, of course, is how powerful the placebo effects can be in certain
research studies. Recall that the antidepressant literature found that virtually
all the antidepressant effects from the drugs came from placebo effects. As
we know, sometimes these belief or placebo effects are so strong that they
allow the experimental subject to change somatic effects as well as feelings
and attitudes. Clearly, in the case of placebo studies, constructed reality is
interwoven with fundamental reality.
Saying that all therapy is placebo and therapists are placebologists sounds
like a good way to summarize therapy in constructed reality; in truth, the
phrase creates confusion and misunderstandings. Since placebos only exist in
fundamental reality and therapy takes place in constructed reality, the phrase
 Beginner’s Mind 151

literally makes no sense. Even worse, it implicitly suggests that therapy is

occurring in fundamental reality and its power is due to placebo. Placebo,
of course, is linked to misconstruals, intentional lying, and a sense that the
elicited effect is, in some sense, unreal, artificial, or insubstantial. These are
unhelpful, confusing, and inappropriate associations.
Contrast that saying to the title of a book on neurolinguistic programming
written by Bandler and Grinder in the 1970s called The Structure of Magic.
The fluid and rapid change seen in the exorcism intervention did appear to
have magical qualities. Using a “magic” metaphor for conscious work in
constructed reality highlights the Dionysian opportunities that emerge when
one lets go of a belief that therapy operates in fundamental reality. In other
words, it’s better to call therapists in constructed reality “magicians” than
“placebologists.” But of course it is not the ritual—not the exorcism inter-
vention—that has the magical qualities. Rather, it is the nature of constructed
reality to be conducive to “magical” change. After all, if it is all made up, how
hard can change really be? The magic is in the milieu, not the intervention.
Beginner’s mind is consciousness designed to work effectively with all
aspects of constructed reality. Expert mind is superior in fundamental real-
ity. Myth and ritual are the building blocks of change in constructed reality;
science and techniques rule in fundamental reality. Discerning the difference
between the two opens the therapist to the magical qualities of change implied
by the Bandler/Grinder title. While it is true that this book emphasizes acquir-
ing charisma—a process which can be intentional and require hard work—it
is also true that simply letting in that everything is possible with little effort in
constructed reality ushers in a sense of effortless power. In this sense, aware-
ness trumps effort. Rumi tells us:

You wander from room to room

Hunting for the diamond necklace
That is already around your neck!

FRAMING AND TRUTH

What is originality? To see something that has no name as yet and

hence cannot be mentioned although it stares us all in the face. The
way men usually are, it takes a name to make something visible for
them.
—Friedrich Nietzsche, The Gay Science (1882)

Another significant threat to sustaining beginner’s mind is the question about

the truth of any intervention. Yalom has already argued that all interventions
152 Chapter 7

are based on “fictions,” but that can hardly be the only word on the subject.
While it is true that constructed reality implies that concepts are invented—
and the therapist gains lots of room to maneuver from this approach—it is
also important to find that “place to stand” to enhance therapeutic power.
Every intervention with a client includes an implicit negotiation between
therapist and client about the validity of the explanations of the current
state—usually a state of suffering―and the recommended path forward.
Clearly the explanation and the path forward must feel “real” to the client.
And they must also feel “real” to the therapist to maximize authenticity and
charisma. Yet in a constructed reality, what is real, what feels real, and what
is simply a construct manufactured to reach a desired goal?
The arbitrary nature of any frame is relatively easy to demonstrate with
virtually any case study. In the following example from my practice, this
discretionary nature of the frame is particularly easy to see because the frame
is “politically incorrect.”

A 49-year-old, divorced, female physical therapist presented with complaints

of depression and anxiety. She explained that she had been raised from birth to
take care of others and now, with both of her children launched into the world,
she felt there was no longer any purpose in living. She had some interest in a
few men but minimized any hopes and expectations that she had in the romantic
arena.
Her caretaking strategy was validated and she was invited to explore the pos-
sibility that fulfillment of her complete life potential required her to have the
ability to form her own individual vision of happiness. In response, she identi-
fied several events in her family of origin which required her to give up any
hope of personal happiness in order to live to serve others. She agreed that these
old mislearnings ought to be discarded if she was going to have any chance at
personal happiness. Since she had a natural albeit somewhat muted attraction to
men, it was easy for her to accept the idea that the ability to conduct a healthy
romantic relationship would signify that her core wound―her lack of permis-
sion to pursue her own happiness―had been healed.
The client went on a series of dates through an Internet dating service. While
she, of course, processed the dates using normal criteria such as degree of attrac-
tion, common values, and fun, she also carefully monitored her own behaviors
and feelings in terms of her “primal wound,” her necessity to live only to serve
others. She finally found someone who both pleased her and allowed her to
operate as a free and unwounded woman in the relationship. She not only felt
much better in general, she also expressed the belief that her experience had
healed her in that: “My ability to give and receive love this way means that I
have given up my sense that I live only to serve others.”

Telling a woman that she needs to heal herself by finding a boyfriend is

clearly “politically incorrect.” In addition, advising a woman who has a
 Beginner’s Mind 153

tendency to lose herself in the service of others to enter a relationship is

fraught with peril; how many women have complained that romantic rela-
tionships require them to give excessively to their lovers. From this point of
view, the fact that this frame proved successful—and the client was clear that
loving someone helped her get over an obsessive need to serve others—is an
unexpected result.
Conversely, it is easy to defend the frame. The client clearly equated
romantic relationships with meeting her own needs; for her, intimate relation-
ships were for her and normal relationships were about serving others. Appar-
ently she saw a romantic relationship as representative of mutuality and other
relationships as a commitment to one-way service. Hence, the politically
incorrect frame served her well.
Exploring additional alternatives, it is easy to imagine that other therapists
would prefer to work directly with her “service-oriented” relationships. They
would follow up on her feelings of exploitation and process those experi-
ences. Another approach might involve exploring why she was so “con-
flicted” about relationships in general. This perspective might recommend a
period of aloneness—both in terms of serving and romance—and investigate
the feelings that arise as a result. In sum, it appears that at least three, if not
fourteen, different approaches would have worked well in this situation.
And that is virtually always the case. If one grants that all the schools of
therapy would see this woman differently, and proscribe different treatment
frames, and all would achieve roughly equivalent results, then Yalom’s dic-
tum that all frames are “fictions” certainly makes sense. Beginner’s mind
embraces the meaning-creating potential of many, many different frames.
Abandoning the concept of the “best” or “most accurate” frame is a necessary
first step for the Reality B therapist.
This can be summarized as: “everything works/nothing really works.” Vir-
tually all positive frames work in terms of their potential to help clients but
none of them work in the sense that they embody ultimate truth or inherent
power. This may be obvious to many therapists but it can still be challenging
to retain this level of fluidity as one works in real time with a client. We all
have Apollonian tendencies which require us to believe that the worldview
we are co-creating with the client is fundamentally real; at this point, we lose
access to all competing realities. Beginner’s mind always cultivates aware-
ness of the ephemeral nature of every frame even while endorsing the func-
tional usefulness of a frame in the here and now.
That said, are there any frames that are superior to others? Jerome Frank
tells us that the one that is most compelling to the client is the best. Tillich
argues that the one that heals an idolatrous ultimate concern or evolves an
existing one is the best. And the research discusses the power of therapeutic
allegiance effects; when the therapist believes in the frame, therapy becomes
154 Chapter 7

more efficacious. These three approaches are, in fact complementary. An

elegantly designed frame will include all three.
Finally, let’s look at one more case study, this one from Milton Erickson,
to further explore beginner’s mind. A seventeen-year-old girl was having
trouble leaving home to go to college. It appeared that she was socially
sensitive and withdrawn because her breasts had failed to develop. She had
already received endocrine therapy to no avail. She was so emotionally labile
that hospitalization was being considered; in fact, when Erickson went to her
home to treat her, she was hiding behind the sofa.
Erickson found she was a good hypnotic subject and made a number of
suggestions to activate her endocrine system and to channel attention—in
some unspecified manner—to her breast area.

This series of suggestions had the multiple purpose of meeting her ambivalence,
puzzling and intriguing her, stimulating her sense of humor, meeting her need
for self-aggression and self-derogation, and yet doing all this without adding to
her distress. It was done so indirectly that there was little for her to do but accept
and respond to the suggestions.
I suggested to her that, at each therapeutic interview, she visualize herself
mentally in the most embarrassing situation that she could possibly imagine.
This situation, not necessarily the same each time, would always involve her
breasts, and she would feel and sense the embarrassment with great intensity, at
first in her face, and then, with a feeling of relief, she would feel the weight of
embarrassment move slowly downward and come to rest in her breasts. I gave
her the additional posthypnotic suggestion that, whenever she was alone, she
would regularly take the opportunity to think of her therapeutic sessions, and
she would then immediately develop intense feelings of embarrassment, all of
which would promptly “settle” in her breasts in a most bewildering but entirely
pleasing way.
I explained that she could, in addition to handling her academic work ade-
quately, entertain herself and mystify her college mates delightfully by the judi-
cious wearing of tight sweaters and the use of different sets of falsies of varying
sizes, sometimes not in matched pairs. She was also instructed to carry assorted
sizes in her handbag in case she decided to make an unexpected change in her
appearance, or, should any of her escorts become too venturesome, so that she
could offer them a choice with which to play. Thus her puckish activities would
not lead to difficulties.
I first saw her in mid-August and gave her weekly appointments thereafter.
The first few of these she kept in person, and they were used to reiterate and
reinforce the instructions previously given her and to ensure her adequate under-
standing and cooperation. After that, she kept, by permission, three out of four
appointments “in absentia.” That is, she would seclude herself for at least an
hour and develop, in response to post hypnotic suggestion, a medium to deep
trance state. . . . The other appointment she kept in person, sometimes asking
for information, sometimes for trance induction, almost always for instructions
 Beginner’s Mind 155

to “keep going.” Occasionally she would describe with much merriment the
reactions of her friends to her falsies.
She entered college in September, adjusted well, received freshman honors,
and became prominent in extracurricular activities. During the last two months
of her therapy, her visits were at the level of social office calls. In May, how-
ever, she came in wearing a sweater and stated with extreme embarrassment,
“I’m not wearing falsies. I’ve grown my own. They are large medium size.
Now tell them to stop growing. I’m completely satisfied.” (Haley, 1993b, pp.
113–115)

The first point that leaps out from this anecdote is Erickson’s refusal to
engage with the level of pathology apparent in this history. The teenager
was hiding behind furniture in a primitive and regressed manner. She was
obsessed with a sexually related body part. This level of anxiety and obses-
sion suggests serious pathology, perhaps a personality disorder or perhaps
a pre-psychotic condition. His intervention, which focused on her sense of
humor, did literally nothing to address this underlying pathology. Offering
Erickson’s treatment plan at a professional case conference would leave the
presenter open to the accusation that he had underestimated the severity of
her disorder. Of course, the success of Erickson’s intervention not only vali-
dates his choice to ignore the diagnostic implications, it also calls into ques-
tion the utility of Apollonian schemas such as diagnosis and a fixed attitude
toward pathology.
His basic frame was twofold and embodies his well-known utilization
approach. Accept her obsessive focus on her breasts but make certain thera-
peutic alterations. First, combine the breast focus with her strong sense of
humor. Second, let the breast focus become a form of mind/body healing—as
I meditate on the breasts, they develop in a natural and healthy manner.
Are these the only right frames? Clearly not. Erickson would have done
just as well using a feminist approach that helped the woman understand that
she is not her breast size. Or he could have explored her upbringing with the
aim of discovering the source of her excessive social anxiety and providing
an alternative set of responses.
Is hypnosis different than the other techniques already discussed? Not from
a research point of view; hypnosis has failed to prove that it is consistently
better than any other psychotherapeutic technique. His results may have been
magical but not because his technique—hypnosis—was magical.
But hypnosis is different than standard talk therapy techniques because
it involves altered states. Altered states exist at the edge of the Net—the
place where the Net ends and the Abyss begins. Altered states are essentially
Dionysian in comparison to the Apollonian style of standard talk therapies.
Especially when altered states are combined with a highly charismatic
therapist, more rapid change is possible. Put in Jerome Frank language, a
156 Chapter 7

therapeutic ritual that includes hypnosis is a ritual that implicitly justifies

and supports rapid and profound change. All that may be true but recall that
some therapists—the more charismatic ones—are better regardless of what
techniques they use and the “altered states” nature of hypnosis does not
guarantee that average therapists become superior if they attain expertise in
hypnosis.
That said, while Erickson takes great pains in his case presentation to
directly avoid taking credit for her eventual breast development, there is cer-
tainly the implication that the therapy may have contributed to it. Recall the
earlier discussion about the line between fundamental reality and constructed
reality: as a general principle, reality is more constructed than normally
believed because of the tendency of Apollonian forces to perceive all reality
as fundamental reality. The implications of this case study—that the mind-
body connection is more powerful than traditional medicine postulates—is an
argument that our bodies also participate in constructed reality. As we think,
so our bodies become.
Returning to the question about framing and truth: our two clinical
examples illustrate that many, many different approaches would have led to
equally successful outcomes. Interestingly, once the stories are told, for many
of us the explanations become “real”; not only do the frames seem correct, it
feels like they are the only possible way to see the situation.
On the one hand, this reification is simply the result of Kahneman’s System
1 and its tendency to create simplified worldviews and assume that everything
exists in fundamental reality. But there is another factor at work as well: the
shared and co-created commitment to healing that exists in the space between
therapist and client. Tillich tells us that every place on the path points toward
the terminus of the path. He argues that each of these moments become sym-
bols that participate in the ultimate goal. In this sense, all authentic healing
has a feeling of being ultimately real. Put in the language of the Abyss, the
frames in therapy are literally fluid and interchangeable—they participate in
the chaotic aspect of the Abyss—but they are simultaneously and paradoxi-
cally real and truthful—they participate in the numinous aspects of the Abyss.

ASSUMPTIONS ABOUT CHANGE

Assumptions about change are deeply imbedded in the culture. In order to

give form to these assumptions, I searched the internet2 for quotes connected
to change and then selected a number that seemed representative.
“Growth is a painful process.”
—Wilma Mankiller
 Beginner’s Mind 157

“The only sense that is common in the long run is the sense of
change―and we all instinctively avoid it.”
—E. B. White

“The key to change . . . is to let go of fear.”

—Roseanne Cash

“If we’re growing, we’re always going to be out of our comfort zone.”
—John Maxwell

“It takes a deep commitment to change and an even deeper commitment

to grow.”
—Ralph Ellison

“Taking a new step, uttering a new word, is what people fear most.”
—Fyodor Dostoyevsky

“Changing is what people do when they have no options left.”

—Holly Black

“The prospect of change is a many-fanged beast, my dear.”

—Christopher Moore

All of these quotes have one thing in common: they caution that growth and
change are demanding, slow, hard, and painful. The association between
pain and change is so ingrained that it is rarely questioned. Yet the small-
est reflection leads to the more accurate conclusion that change is some-
times hard, sometimes easy—sometimes quick and painless and sometimes
requires courage and perseverance. Why this default idea that change is so
difficult?
The answer is straightforward: in every culture, Apollonian forces operate
to sustain the Net. Their first job is to support the concept that constructed
reality is actually fundamental reality. The second major priority is to resist
change and promote stability. Given that there are Apollonian forces in
psychology, it stands to reason that therapists will be trained to conceive of
change as difficult, slow, demanding, and sometimes impossible. This may
seem counter intuitive—that a field dedicated to change and healing would
be limited by encouraging assumptions that such change is unlikely and chal-
lenging—but this simply reflects the power of Apollonian forces.
158 Chapter 7

The quotes above demonstrate that the resistance to change is not limited to
the mental health field, it is a principle that is pervasive in the culture. Exam-
ining the quotes, one can easily see the standard Apollonian stance toward
change: it is a long, slow, painful, and difficult process requiring sacrifice,
perseverance, and courage. The literary record is full of inspiring quotes
aimed at encouraging individuals to stay committed to the change and growth
process in spite of fear and obstacles. Many therapists, coaches, and motiva-
tional speakers are fond of telling individuals to keep on going, that they are
in “good company” in terms of their fear of moving forward. They promise
that if the individual perseveres, a brighter future lies just ahead. Sometimes
they complement these encouraging statements with not-so-subtlety veiled
threats that refusal to change leads to lost opportunities, a wasted life, or even
a kind of “soul death.”
Current ethics in psychology require psychologists to begin the therapeutic
relationship by giving the new client an Informed Consent Form. The form
has a number of components; the part most relevant to our discussion is the
heart of the form where the psychologist is required to explain the risks and
benefits that are implicit in the process of psychotherapy. Following are
excerpts taken from the Sample Informed Consent Form from the American
Psychological Association Insurance Trust.

Psychotherapy is not easily described in general statements. It varies depending

on the personalities of the psychologist and patient, and the particular problems
you bring forward. There are many different methods I may use to deal with the
problems that you hope to address. Psychotherapy is not like a medical doctor
visit. Instead, it calls for a very active effort on your part. In order for the therapy
to be most successful, you will have to work on things we talk about both during
our sessions and at home
Psychotherapy can have benefits and risks. Since therapy often involves
discussing unpleasant aspects of your life, you may experience uncomfortable
feelings like sadness, guilt, anger, frustration, loneliness, and helplessness. On
the other hand, psychotherapy has also been shown to have benefits for people
who go through it. Therapy often leads to better relationships, solutions to spe-
cific problems, and significant reductions in feelings of distress. But there are no
guarantees of what you will experience.
. . . Therapy involves a large commitment of time, money, and energy, so you
should be very careful about the therapist you select.

Note how well the Informed Consent Form specifies the assumptions about
change noted above. Therapy is going to be hard work. It is painful and you
will experience uncomfortable feelings. It is slow and takes large commit-
ments of time, money, and energy. And, because there may be resistance
or interference from a variety of factors, the outcome is far from certain.
 Beginner’s Mind 159

In fact, you should know that psychotherapy is not a powerful process with
a guaranteed result but rather a more modest intervention that only helps
occasionally. This form is the client’s first introduction to the concept of
psychotherapy; it appears to be designed more to inhibit change than to
encourage it.
The following amusing, but revealing, joke about psychologists makes
some of the same points as the Informed Consent Form.

Question: How many psychologists do you need to change a light bulb?

Answer: One, but the light bulb has to want to change.

The implication in this joke is that psychotherapy is a weak process that

needs cooperative and enthusiastic participation by the client in order to be
effective. Compare that to a more robust intervention such as an antibiotic
prescribed for a bladder infection. In the case of the powerful intervention,
antibiotics, the desired outcome will occur whether the patient has a coop-
erative attitude or not. In other words, the need for cooperation from the
client highlights the weakness of the psychotherapeutic effect and implies
that, compared to robust interventions, the effect size of psychotherapy is
relatively small.
Western culture assumes there is a solid self—with an established
sense of identity—that is confronting this opportunity to change. There
are lots of theories about how this self is formed—genetic/biochemical
contributions, early life traumas, learned and modeled behaviors, etc.—
but all the theories support one’s inner experience that “I exist,” “I am
a solid person,” and “I am a stable person across time and place.” It is
assumed that change threatens the stability and comfort zone of this self
and, therefore, change is associated with the pain of letting go, releasing
the secure sense of self, and stepping into the unknown. The concept of
“resistance” in psychotherapy—the feeling that the client is slowing or
stopping change and thereby supporting the self as it currently exists―
has been central to teaching and understanding therapy since the incep-
tion of the field.
This sense of the solidness of the self can be extended to the idea that real
change is impossible. At moments of despair—with themselves, their loved
ones or their clients/patients—people become susceptible to the fear that
“people never really do change.” Examine the following three quotes again
selected from popular quotes on the web.3
“People don’t change, they just have momentary steps outside of their
true character.”
—Chad Kultgen
160 Chapter 7

“We do not escape our boundaries or our innermost being. We do not

change. It is true we may be transformed, but we always walk within
our boundaries, within the marked-off circle.”
—Ernst Jünger, The Glass Bees

“The only time a woman really succeeds in changing a man is when

he’s a baby.”
—Natalie Wood

The Kultgen quote embodies the common sense notion that there is only the
appearance of change. Given time and varying experiences, individuals will
regress back to their “essential” self and their basic identity. The Wood quote
may have an amusing character but it emphasizes the idea that by adulthood
all real ability to change is gone and we need to accept people as they are.
In fact, this concept of the stability of the self and resistance to change is
so prevalent it has been formalized and reified in the psychological literature;
people who can’t change or have an extremely difficult time changing—
even when their lives are profoundly dysfunctional―are called personality
disorders.

(a personality disorder is) [a]n enduring pattern of inner experience and behav-
ior that deviates markedly from the expectation of the individual’s culture, is
pervasive and inflexible, has an onset in adolescence or early adulthood, is
stable over time, and leads to distress or impairment. (DSM IV)

In this definition of personality disorder, one can see the characteristic

dilemma of change carried to the extreme. The individual with a personal-
ity disorder holds on to their sense of self in spite of the fact that it deviates
from strategies that predict success. In other words, they are committed to
staying the same even if that choice is regularly and repeatedly punished by
their social group and results in significant pain and distress. In professional
psychology the debate about personality disorders lies between advocates
who believe that some personality disorders can change slowly and gradually
if they are given lots of time, massive amounts of therapy, and behavioral
incentives, and practitioners that believe it best to accept the personality
disorders as they are—they aren’t going to change; one should, therefore,
teach their family members to cope with them and the individual to suffer
minimally given their fixated state.
All of the above seems to be common sense until one contrasts it with the
actualities of human existence on the planet. Examine the following popular
quotes again harvested from the internet.4
 Beginner’s Mind 161

“It is the greatest mistake to think that man is always one and the same.
A man is never the same for long. He is continually changing. He
seldom remains the same even for half an hour.”
—G. I. Gurdjieff

“The fact is that five years ago I was, as near as possible, a different
person to what I am tonight. I, as I am now, didn’t exist at all. Will the
same thing happen in the next five years? I hope so.”
—Siegfried Sassoon

“Change is inevitable—except from a vending machine.”

—Robert C. Gallagher

In truth, everything is in flux around us all the time. Even more importantly
our physical, mental, and emotional bodies are moving relentlessly through a
developmental process from birth to death. Moreover, since there is no uni-
fied, internal self, our own personality varies significantly from moment to
moment as different ego states sequentially take the stage.
People change effortlessly and profoundly simply when they get a new job,
or move to a new city, or get a new boyfriend or spouse. Financial success or
failure, the presence of disease or disability, or the loss of a significant other
often makes us completely different people. Individuals get exposed to a new
idea, or spiritual belief, or political affiliation and they vow to reorganize and
transform their lives accordingly and, voila, they do.
The problem in life is not the difficulty of change; rather, it is the difficulty
of staying the same. Is it harder work to evolve or harder work to maintain
stability?
Imagine writing a new Informed Consent Form without the implicit
­Apollonian bias against change. It might go something like this.

Welcome to the psychotherapy change process. You are about to embark on a

modern version of a human experience as old as time and as natural as a youth
becoming an adult. You begin with a positive prognosis. First, even without
making a conscious effort—such as the one you will exert as a psychotherapy
client—many psychotherapy issues resolve by themselves. Second, research
suggests that therapy helps about 75% of participants. In sum, while there is no
guarantee of success, given your efforts and the efforts of your therapist, it is
likely that the change you desire will not only happen, but happen much more
quickly and profoundly than you might imagine. Moreover, most clients report
experiencing additional positive changes that occur through therapy beyond
their initial target.
162 Chapter 7

Psychotherapy is the safest process in the medical field in terms of side

effects. In comparison to other approaches such as surgery, medicine, or physi-
cal therapy, there are few risks. And the downsides of therapy are fairly obvious
and expected: sometimes a client will be urged to talk about uncomfortable feel-
ings; occasionally she will be confronted by the therapist regarding life choices;
and at other times the client might experience some regrets. Other than these, the
biggest risk is that you will fall into the less than 20% of clients who do not find
therapy beneficial and feel they have wasted their time and money.

In this informed consent example, the actual risks and benefits of therapy are
presented without the negative Apollonian slant. It is clearly more accurate
than the actual Informed Consent Form and, from the standpoint of instilling
positive expectations, it becomes a document that might actually serve clients
instead of acting as a barrier to growth and change.
Some might argue that psychology is required to have a negative and
conservative Informed Consent Form to avoid law suits. Yet we are told
in our mandatory ethics classes that our real risk of being sued only arises
secondary to much more serious faults than using an encouraging Informed
Consent Form; we are going to get sued if we operate outside our compe-
tence or sleep with our clients, not because we tell them quite accurately that
psychotherapy outcomes tend to be positive. Do ethics require us to offer a
negative and conservative consent form? On the contrary, ethics requires
us to serve the client’s highest needs and clearly that includes encourag-
ing them to be open to the benefits of psychotherapy. In sum, our existing
Informed Consent Form is clearly an attempt by Apollonian forces to sustain
stability; the ethics of a profession dedicated to healthy change mandates a
far different form.
The Informed Consent Form is a simple and concrete example of Apol-
lonian influence. However, the real genius of the Apollonian approach is to
convince therapists—as opposed to clients—about the slowness of change
and the relative ineffectiveness of psychotherapy. Essentially, the more train-
ing a therapist has, the less they believe that change is easy and possible.
A life coach believes change is easier than a master’s level clinician. The
doctoral-level clinician knows many more factors that preclude change than
the two lower levels of training. Duncan et al. comment:

Too many pathology-based prognostications about clients pervade the field. It

would seem that a field dedicated to helping people change would believe that
change is not only possible but probable. Believing in the client’s propensities
for change seems to follow the data presented in this chapter. Given the amount
of variance accounted for by the client relative to models, allegiance to this
belief is perhaps more important that any commitment to a given approach.
(Duncan, Miller, Wampold, & Hubble, 2010, Kindle Locations 2706–2709)
 Beginner’s Mind 163

Apollonian influences are also apparent in research priorities. At present,

the research that most excites interest and most attracts funding is the neu-
roscience of mental health. There are almost daily articles in leading papers
and on the internet discussing the latest discoveries that show that complex
behaviors and choices are actually determined by genetics or, sometimes, by
a dysfunctional part of the brain. As pointed out in chapter 3, a number of the
neuroscientists—who are deeply committed to the “intricate machine” theory
implicit in pragmatism and most of science—question if there is any free will
at all. To such theoreticians, change is impossible by definition as there is no
independent consciousness to “stand in” to serve as a foundation for change
and growth. In sum, there is a culture-wide campaign for stability, structure,
and permanence. And greater training in the mental health field correlates
highly with more exposure to material that argues against change or limits
change to slow, modest, and partial.
Returning to the discussion of placebo, there is a sense that placebo is a
powerful force in its own right; when we succeed in activating the placebo
effect, we are enabling a strong mental force that can serve positive or nega-
tive ends. However, when placebo is examined from a Reality B perspective
it is more helpful to think of it as a power that can disable the Apollonian
forces. In this sense, the belief that placebo mobilizes powerful inner
resources is a misunderstanding. The actual strong effects are Apollonian;
Kahneman’s System 1—plus social concordance―acts to keep clients stable
even though the stability is not in their best interests. If they are sick, they
remain sick; if they are depressed, they remain depressed, and if they have an
anger problem, the problem continues. The client wants to be healthy or in
a positive mood or calm but they cannot because if “simply wishing made it
so,” reality would become unstable and fragile.
Feeling the power of the Apollonian forces in every moment is a vital
part of cultivating beginner’s mind. Understanding that individual identity is
fluid and barely held together by social concordance and beliefs is necessary
to function therapeutically in constructed reality. Why is this definition so
important? Because it highlights the fragility of the Net, emphasizes the ease
of change, and helps focus interventions.
The ability to work effectively with Apollonian forces by adopting a Dio-
nysian perspective is well illustrated by the following dialog from the Matrix.
In the following scene, Neo, the protagonist, encounters a young adept who
is capable of bending metal spoons with his mind.

Boy: Do not try and bend the spoon. That’s impossible. Instead only try to realize
the truth.
Neo: What truth?
Boy: There is no spoon.
164 Chapter 7

Neo: There is no spoon?

Boy: Then you’ll see that it is not the spoon that bends, it is only yourself. (Silver,
Wachowski, & Wachowski, 1999)

The simple interpretation of this dialog is that since they are in the Matrix,
there is no actual spoon; in truth there is only a computer program’s repre-
sentation of a spoon. Within the reality of the program, the spoon is real. To
understand “no spoon,” change yourself by recognizing that the program is
not reality. Once you know the spoon is not real, it is easy to bend it.
Returning to Reality B, the seeming solidity of the spoon corresponds to
the seeming solidity of the clinical syndrome. The sense of “I am sick,” “I am
neurotic,” is difficult to move because of the stabilizing Apollonian forces.
The therapist negates the reifying power of the Apollonian forces by rec-
ognizing they are constructed—they are “made up.” This negation requires
altering normal reality or “bending yourself.”
When one asks, “is change easy or hard?” in truth, one is not actually ask-
ing about the difficulty of change. In reality, one is asking the professional
to identify as an Apollonian or a Dionysian. Apollonians are required to
answer this question with the assertion that change is hard and it takes a long
time and much effort. Dionysians have just the opposite experience. Gifted
therapists move through the therapeutic world with a sense that it is highly
likely that they are going to be helpful to the client. Moreover, they delight
in helping clients who have confounded standard therapeutic approaches and
love to show how people are more capable of change than might be expected.
Such therapists cultivate beginner’s mind and recognize implicit Apollonian
messages.

The real difference between God and human beings, he thought, was that God
cannot stand continuance. No sooner has he created a season of a year, or a
time of the day, than he wishes for something quite different, and sweeps it all
away. No sooner was one a young man, and happy at that, than the nature of
things would rush one into marriage, martyrdom or old age. And human beings
cleave to the existing state of things. All their lives they are striving to hold the
moment fast. . . . Their art itself is nothing but the attempt to catch by all means
the one particular moment, one light, the momentary beauty of one woman or
one flower, and make it everlasting. (Dinesen, 1991, p. 121)

In this final quote, Dinesen discusses the fundamental inevitability of change

and the natural Apollonian tendency to resist it. The Net requires ongoing
maintenance, like any living structure, and it is healthy and right to do so.
However, for the professional dedicated to change, Apollonian priorities,
while appropriate and helpful in the correct context, are the embodiment of
resistance in psychotherapy. Recognizing their hidden and constant presence
 Beginner’s Mind 165

is vital. And a formal commitment to seeing reality as fluid and mobile is

central to enhancing therapist efficacy.

NOTES

1. All identifying details have been altered in this case and subsequent cases in
order to protect the confidentiality of my clients.
2. It is well known that the internet quote sites are not entirely accurate. Since the
quotes are typically posted by individuals, quotes may have mistakes and they may
even be attributed to the wrong author. I gathered quotes from internet sites because
I was attempting to sample pop culture. In other words, such quotes represent what an
average individual might think about change.
3. It is well known that the internet quote sites are not entirely accurate. Since the
quotes are typically posted by individuals, quotes may have mistakes and they may
even be attributed to the wrong author. I gathered quotes from internet sites because
I was attempting to sample pop culture. In other words, such quotes represent what an
average individual might think about change.
4. It is well known that the internet quote sites are not entirely accurate. Since the
quotes are typically posted by individuals, quotes may have mistakes and they may
even be attributed to the wrong author. I gathered quotes from internet sites because
I was attempting to sample pop culture. In other words, such quotes represent what an
average individual might think about change.
 Chapter 8

Wizards among Us

Everyone goes with the flow . . . but the one who goes against the flow
becomes someone remarkable in life.
—Swami Vivekananda, The Complete Works
of Swami Vivekananda (1907)

What is real and what is unreal is not an easy question to answer once con-
structionism is accepted as an organizing principle. Human suffering is, of
course, real to a therapist. Without the perception of suffering, there is no
compassion, no motivation to be of service, and no ability to make a connec-
tion or build rapport. However, being entranced by the client’s current iden-
tity results in the therapist losing the ability to move fluidly and creatively;
even more important, she can start to believe that her client’s dilemma is
“real” and have significant difficulties imagining her in any other state.
Since the Net is socially constructed and culturally defined it is both real—
in the sense that it works to stabilize an individual and to have opportunities
for health and growth—and unreal in the sense that there is no right or wrong
shape or construction. Because of the fluidity of reality, the exact shape of
our own Net is highly determined by social and cultural conventions and
especially influenced by high status people—people who exercise dispropor-
tionate influence over how we structure our net. Wampold puts it this way.

The point here is that a claim could be made that psychotherapy is a social
healing practice. Or perhaps better said, psychotherapy utilizes evolved human
propensities to help clients change (Wampold and Budge 2012). Lieberman, in
his review of the “hard wiring” of the social nature of humans, notes . . . [o]ur
brains are designed to be influenced by others. (Wampold & Imel, 2015, Kindle
Locations 1280–1284)

167
168 Chapter 8

From a constructionist point of view, every human being comes with the
innate ability to be socialized into the prevailing reality. Every successfully
socialized human has a capacity to take direction from the culture in general
and from key individuals in particular. And this direction is not simply about
learning a language or acquiring social customs; rather, we have the ability
to take direction about the basic formation of the fabric of reality. No one has
to learn how to do this. We are all already prepared to take our cues from
our social group and key individuals. If we didn’t have this ability we would
not be fully capable of socialization—in short, we would not be fully human.
People are always marveling about the foolishness—or even insanity—of
cult behavior. How did Jones get his followers to drink the poison Kool-Aid;
why did the Heavens Gate followers employ castration and eventual mass
suicide to reach their spiritual goals? Of course these stories are human trag-
edies, but they also document how profoundly reality can be altered given
the combination of a charismatic leader and a validating peer group. In Ger-
many, regular citizens participated in the Holocaust. In the famous Milgram
experiment, normal students administered electric shock at seemingly horrific
levels. Examples like these demonstrate that humans are remarkably capable
of shifting reality when the conditions are right and a charismatic leader pro-
vides direction.
This human ability to take direction suggests a new definition of the highly
effective therapist: the effective therapist is one who is recognized by clients
as having the innate authority to reformulate our existing view of reality
simply because he directs us to do so. Of course, it is not that easy to be rec-
ognized as this kind of key individual; the need to be stable requires us to be
discerning about who we empower as an authority figure and reality definer.
If we allowed just anyone to affect us, the world and our identity would be
in a state of constant turmoil. This is where the concept of “status” becomes
important. From a Reality B point of view, status can be defined as the
amount of power we give the other to define and redefine our reality. Obvi-
ously parents were the original high status people although, as time passes,
parental status tends to shrink. Similarly bosses, mentors, famous people, rich
people, and powerful people may become high status people to us.
The problem with using the term “high status” to refer to therapeutic
wizards and their power as change agents is that status is so associated with
wealth and fame. Wealth and fame are often criticized as shallow and ulti-
mately meaningless; in contrast, the kind of personal power we are discussing
here is deep and profound. From the Tillichian point of view, status is asso-
ciated with idolatrous ultimate concerns and the healing power of therapists
needs to flow from authentic ultimate concerns.
“Charisma” tends to be a more useful term than status. Often defined as
“personal magnetism,” it also has spiritual connotations dating back to its
 Wizards among Us 169

Greek origins which are connected with “grace” and “gift.” In some spiritual
traditions it refers to a divinely bestowed power. And, while the term is often
used for leaders, politicians, and even actors—and hence can bring up the
same shallow, idolatrous associations as “status”—the primary references are
to magnetism, grace, and spiritual power. While some of its connotations are
imperfect, we will use it to describe the characteristic that highly effective
therapists possess that sets them apart from the more common kindness and
wisdom possessed by ordinary therapists.
The concept of “if I say it, it becomes so” is a magical idea. It is a statement
that affirms that reality is directly created by thought, intention, and action.
And, of course, in constructionism this kind of magical thinking is literally
true. Since virtually everything is made up—and validated by mutual consent
between myself and others—the therapist is capable of creating a reality
where the client is healthy and generative simply by fiat. If the client concurs
with this new view of reality, then it exists. And this new reality is just as real
as any other view of personhood, identity, pathology, or health.
In this sense, constructed reality is a kind of “Wild West” where laws hold
no sway and reality is created by social contract and the power of remark-
able individuals. Given that this is so, such individuals should stand out; we
should be aware of their presence because they are not bound by the laws that
“we mortals” need observe. In reviewing their work and results, we will have
trouble making sense of how they operate since we try to describe their pat-
terns and results using words and concepts from fundamental reality.
However, what makes them remarkable is that they have somehow dis-
covered that they are not bound by socially constructed limits and have gone
on to create their own rules. Exceptional therapists will achieve remarkable
results. How they work will be shrouded in mystery. And analyses based
on fundamental reality—including attempts to distill general principles and
replicable techniques—will fail to capture their essential functioning. This
failure is due to the fact that they are operating in constructed reality and,
hence, are operating outside of Reality A rules and limitations.
Let’s begin by looking at several examples of therapeutic wizards in
action. The first example, from Milton Erickson, has been chosen as a simple
demonstration of the power of a therapeutic wizard to alter reality with a
simple suggestion.

As an example, I recall a demonstration Erickson once did before a large audi-

ence. He asked for a volunteer and a young man came up and sat down with him.
Erickson’s only trance induction was to ask the young man to put his hands on
his knees. Then he said, “would you be willing to continue to see your hands on
your knees?” The young man said he would. While talking with him, Erickson
gestured to a colleague on the other side of the young man, and the colleague
170 Chapter 8

lifted up the young man’s arm and it remained in the air. Erickson said to the
young man, “how many hands do you have?” “Two, of course,” said the young
man. “I’d like you to count them as I point to them,” said Erickson. “All right,”
said the young man, in a rather patronizing way. And Erickson pointed to the
hand on one knee, and the young man said, “one.” Erickson pointed to the
vacant other knee, where the young man had agreed to continue to see his hand,
and the young man said, “two.” Then Erickson pointed to the hand up in the
air. The young man stared at it, puzzled. “How do you explain the other hand?”
asked Erickson. “I don’t know,” said the young man. “I guess I should be in the
circus.” That hypnotic induction took about as long as it took me to describe it
here. (Zeig, 1982, p. 11)

Now, it is certainly possible to explain the suggestibility of the young man by

noting that he was a volunteer for a hypnosis demonstration and hence, might
be particularly open to manifesting trance phenomena. In addition, he was in
front of a large audience and the presence of that many people focusing their
gaze on him could put anyone in an altered state. Moreover, he had probably
heard that Erickson was a famous hypnotherapist and that might have made
him particularly open. Even given these and other factors conducive to an
altered state, Erickson’s rapid trance induction was still remarkable.
Erickson used no overt induction techniques. And yet he effortlessly
achieved the very advanced trance phenomena of a positive hallucination.
Clearly Erickson was capable of influencing a great many individuals with a
simple “wave of his mind.”
This is an interesting vignette not only in terms of illustrating Erickson’s
skill and charisma, but also in the way it points to Kahneman’s System 1 and
System 2. This vignette is an almost perfect parallel with the optical illusion
of the figures on the train track. In this vignette, System 1 is clearly in trance
and sees three hands and System 2 is having great difficultly explaining
the results. The manner in which System 2 is an apologist for System 1 is
illustrated clearly. Recalling that System 1 is also responsible for sustain-
ing the Nomological Net gives us another perspective on why intellectual
understandings so often fail to help clients improve. The insight is limited to
System 2 and never touches System 1. Since clients’ misconstruals, self-dep-
recations, and the source for virtually all symptoms lie in System 1, System
2 insights are unlikely to be helpful.
Erickson had an early understanding of the difference between the two
systems and oriented almost all of his interventions to System 1. This, of
course, often made his work look magical, inexplicable, and unpredictable—
all words which describe confusion between fundamental and constructed
reality. From the point of view of charisma and being remarkable, however,
this kind of nonintellectual approach was very helpful. Now let us examine a
second Erickson example.
 Wizards among Us 171

E: I like volunteers and I also like to pick my volunteers. The one I’d like to pick
is the pretty girl wearing the white hat who keeps hiding behind the pillar.
S: All the way from Colorado Springs my husband urged me to act as a subject. I
told him I didn’t want to.
E: Now, notice that you thought you didn’t want to. And now that you’ve come
out entirely from behind that pillar, you might as well come all the way to the
platform.
S: (As she steps forward) But I don’t want to.
E: While you continue to come forward please, don’t go into a trance until you sit
all the way down in this chair. As you are on the platform, you know you are not
in a deep trance but you are getting closer to that chair and you are beginning to
recognize you don’t care whether or not you are going into trance. The closer you
get, the more you can recognize the comfort of going into a trance. But don’t go
all the way in until you sit all the way down in the chair. All the way down. (said
as she is in the process of sitting down.) You are all the way down in the chair all
the way from Colorado Springs.
You know you did not want to go into a trance. You knew you would prefer
something else. As you think it over there is something else. So why don’t you
look at it?
S: (looking at a blank wall) I get so much pleasure watching those skiers through
my kitchen window.
E: What else enhances it?
S: I always keep the hi-fi on while I watch the skiers. That is the easiest way to
wash the dishes. . . .
E: I think you might like to include hypnosis in your future. Suppose you ask me
about it after you are awake.
S: (She awakens and looks around the platform.) I told my husband I would not
volunteer as a hypnotic subject! I was hiding behind that pillar and now I’m here?!
I must have been in a trance. (Erickson, Rossi, & Rossi, 1976, pp. 118–121)

Rossi makes a number of comments about Erickson’s work with this woman.
He emphasized the way in which Erickson would highlight truisms (you are
on the platform) and link it to suggestions (you are not in a deep trance). He
noted embedded suggestions (whether or not you are going into a trance.)
and contingent suggestions (but don’t go all the way in until you sit all the
way down). And “over there is something else” becomes an invitation to
review a meaningful memory. Rossi’s commentary is interesting and instruc-
tive; at first glance, it appears accurate and helpful. However, underlying this
commentary is the implication that Erickson’s words are why the client went
into trance and experienced certain trance phenomena.
Here’s the problem. Imagine that you are on the stage and invite some-
one up using Erickson’s exact dialog. What the probability that they will
be in deep trance as they sit in the chair? Low probability, right? That’s
172 Chapter 8

because you’re aware that you won’t have sufficient confidence and cha-
risma to ensure that she goes into trance. And you also suspect that the
client will somehow read your lack of confidence. This will result in the
client simply walking up to the chair and sitting down in a normal state of
consciousness.
Erickson was not only famous for achieving change using trance and hyp-
nosis, he could be equally effective using straightforward, direct suggestions.
Take a look at the following example.

A woman came to see Erickson because she wanted to lose weight and quit
smoking. She said, “I can’t resist eating and I can’t resist smoking, but I
can resist exercise, and I do.” Erickson learned that she was religious and so
extracted her most solemn promise that she would follow his instructions. She
lived in a two story house. Whenever she wanted a cigarette, she was to go to
the basement where she kept her matches and set one on top of the box. Then
she was to run up to the attic where she would keep her cigarette, then run back
down to the basement to light and smoke it. If she wanted some cake, she was to
cut a thin slice, then run around the outside of her house before she ate it. If she
wanted a second slice, she was to cut a thin one, then run around the house two
times before eating it, and so forth. Soon she cut down on cigarettes and began
reducing nicely. (Zeig & Munion, 1999, p. 74)

Here we have a case where a single, short intervention cured both a smoking
and a weight issue. Zeig and Munion speculate that an important therapeutic
factor is that Erickson changed how the eating and smoking would occur
without forbidding the behaviors. From the case study, Erickson apparently
gave some credit to the religious nature of the client and the motivating factor
of a solemn promise. Those are interesting theories. But, ask yourself again,
if you followed these instructions exactly, what is the chance that you could
do one session cures of weight and smoking? If solemn promises and chang-
ing how a behavior occurs are the active factors, then all of us should be able
to replicate this successful case. However, if the research is correct—and
there is no inherent power in techniques—then the active factor in these two
cases is Erickson’s charisma. The active factor isn’t what he did but who he
was. Put another way, Erickson could apparently do pretty much anything he
wanted and still get good results.
Now let us examine a different example of a therapeutic wizard, Frank
Farrelly. As can be seen below, Farrelly seemingly works without formally
creating altered states.

A young woman was referred for therapy who had a variety of problems
in both task performance and relationship areas. She was gradually able to
achieve much better in her work but still continued not to date. She finally
 Wizards among Us 173

confessed with some embarrassment that when she was a young girl and
her breasts begin to develop, she went to her mother and told her about her
problem. The problem was that, though her right breast fitted her bra, her left
breast “rattled around like a goober pea in a fuel oil barrel.” Her mother took
her to her family physician who took the bra off the frightened young adoles-
cent, looked first at one breast and then at the other and issued this dictum,
“this is not an uncommon phenomenon.” She then was told to dress and return
home. Horror struck, she felt that she had a combination of leprosy, polio,
and various venereal diseases. When she began to date boys, she immediately
ran into the problem about their wanting to pet; her response was simply to
avoid the situation and, as a result, she usually had only one or two dates with
each boy.
Therapist: you mean you’re embarrassed and ashamed for them to find out that you
got that weird left tit?
Client: (embarrassed, hanging her head) I don’t like the way you put it but, yeah,
that’s about it.
Therapist: so that’s why you’ve been avoiding half the human race! (He pauses for
a moment) well, hell, now that I think of it, your behavior makes sense. Because
if you were to go out on dates with guys—guys, being guys, would naturally want
to pet and get all they could off of you (the client nods), and once they got your
blouse open, there could only be three possible reactions that a fella could have
toward you.
Client: (curiously but simultaneously embarrassed) what are they?
Therapist: (very seriously) well, one reaction would be that he would hastily but-
ton up your blouse and say in an embarrassed manner, “I’m sorry, I didn’t know
you were a crip.” A second reaction might be that he would get all heated up and
say, “Whoopie, I’ve always wanted to do it to a crip!” And the only other possible
reaction that a guy could have would be that, once he had unbuttoned your blouse,
he would stare at your weird left tit and exclaim, “hold it right there, will you? Let
me get my Polaroid swinger—the guys back at the frat house will never believe it
when I tell them.”
The patient stared at me throughout this and finally with a weak grin stated,
“yeah, that’s what I feel would happen, but I’ll never really find out if I just sit
here and talk and talk about it with you.” I got anxious at this point and told her
that time was up and that we’d have to discuss it further the next time. As she
was about to leave I remarked, “I like to name my interviews, so I thought I
would call this “the weird left tit interview.” She laughed and said, “that sounds
like an appropriate title for it.”
The next interview she came in looking like the cat that swallowed the 400
pound canary. I greeted her with, “well, gorgeous, what the hell have you been
up to since I saw you last?” Quite briefly, she explained that she had gone out
and, with much fear and trepidation, had “hustled” a guy and had gone up to
his apartment with him. They had shed their clothes and, while in their birthday
suits, were having fun and games. Right in the middle of the proceedings she
174 Chapter 8

called his attention to the fact that her left breast was smaller than her right one.
His response was to look at one and then the other and give a client centered
response: “oh, yeah, you feel that it is, huh?” and immediately resumed his
activities. She felt like an immense, eight year old lead weight had suddenly
been lifted from her shoulders and she experienced a marked sense of relief at
his acceptance of her. (Farrelly & Brandsma, 1981, pp. 67–69)

Farrelly calls his approach “provocative therapy,” and this case clearly illus-
trates the meaning of that title. His behavior was entirely provocative; put
more specifically, it was rude, inappropriate, lacked empathy, and was insult-
ing. Of course, it could also be interpreted as Farrelly consciously acting out
the inner voice that had been tormenting the client all these years. However,
any therapist who hoped that the young woman would see things this way is
taking quite a gamble.
From a Reality A perspective, Farrelly was acting in a socially inap-
propriate manner, particularly for a therapist-client relationship which is
typically characterized by kindness, empathy, and understanding. This was
confusing behavior, particularly from a high status mental health profes-
sional, and understandably threw the woman into a range of uncomfortable
emotions—embarrassment, the “weak grin,” and hanging her head. In short,
Farrelly, without any kind of formal induction, quickly put his client into
an altered state.
The “normal” reaction to such unexpected behaviors from the therapist
would be either anger or complete collapse. In this situation, however,
she somehow quickly rallied and left with a laugh. What made that pos-
sible? Obviously the woman somehow discerned that Farrelly’s strange
behaviors were designed to help her and left with resolve and positive
intentions.
Did Farrelly develop a new technique? Hardly—most therapists attempt-
ing such an intervention would discover that their efforts were rewarded
by clients who fail to return and/or malpractice lawsuits. Clearly Farrelly
“got away” with such behaviors because the client recognized him as a key
individual—an individual who has a right to break any rules because such
individuals essentially make all the rules. In sum, the client somehow sensed
Farrelly’s charisma and decided to allow him to guide her.
Like many therapeutic wizards, Farrelly’s own explanations of his work
are both helpful and obfuscating. First, he believes that “expert mind” often
leads to false conclusions.

Doom and gloom prognostic statements regarding clients’ lack of ability are
rampant in the clinical field and are probably much more a reflection of the
individual clinician’s subjective reaction of helplessness and hopelessness than
any objective statement regarding the client. (1981, p. 41)
 Wizards among Us 175

Second, he shows the characteristic optimism of most therapeutic wizards.

Regardless of the client’s apparent psychopathology, Farrelly expects a posi-
tive outcome. Change is seen as relatively easy and the client’s identity is
relatively fluid.

The Client’s maladaptive, unproductive, antisocial attitudes and behaviors can

be drastically altered whatever the degree of severity or chronicity. (1981, p. 43)

Farrelly believes that clients can respond to reality, are not as fragile as they
seem, and the limitations of a traumatic childhood can often be ignored.

People make sense; the human animal is exquisitely logical and understand-
able (1981, p. 47). . . . The psychological fragility of patients is vastly over-
rated both by themselves and others (1981, p. 42). . . . (And) . . . Adult or
current experiences are as at least if not more significant than childhood
or previous experiences in shaping client values, operational attitudes, and
behaviors. (1981, p. 44)

Farrelly has discovered that his clients are not bound by their past traumas,
that change is possible, and that substantial change—even with badly trauma-
tized clients—is relatively easy. He seems to have freed himself from the lim-
iting nature of various psychological assumptions. Of course, his experiences
as a key individual—more specifically, that his clients change pretty much no
matter what he does—are likely to make him an optimist, an optimist who can
afford to discount preexisting conditions and client frailties.
Then with the next quote, Farrelly gives the credit for his successes to a
specific technique: “The expression of therapeutic hate and joyful sadism
toward clients can markedly benefit the client” (1981, p. 48). Later in his
book he takes this same idea and expands it into what he calls his “Central
Hypotheses.”

If provoked by the therapist (humorously, perceptively, and within the client’s

own internal frame of reference), the client will tend to move in the opposite
direction from the therapist’s definition of the client as a person. . . . (And) if
urged provocatively (humorously and perceptively) by the therapist to continue
his self-defeating, deviant behaviors, the client will tend to engage in self- and
other-enhancing behaviors which more closely approximate the societal norm.
(1981, p. 52)

Now, it is unlikely that Farrelly had ever carefully reviewed the outcome lit-
erature and understood that techniques are not responsible for change. More-
over, much as Farrelly’s successes with his unorthodox approach argued that
he and the clients were operating in constructed reality, it seems likely that he
continued to believe that therapy occurred in fundamental reality; in short, he
176 Chapter 8

thought he had found a technique—therapeutic hate and joyful sadism—that

was responsible for his positive results.
Subsequent technique developers agreed and renamed Farrelly’s central
hypothesis, “paradoxical therapy.” Weeks and L’Abate (1982) wrote an
entire book about paradoxical therapy. Here is their definition of the term.

Like a contradiction, a pragmatic paradox gives a person no choice. “Thus, if the

message is an injunction, it must be disobeyed to be obeyed; if it is a definition of
self or other, the person thereby defined is this kind of person only if he is not, and
is not if he is.” Accordingly, paradoxical therapy is based on the principle that a
person is expected to change by remaining unchanged. The classic example of this
principle and of the pragmatic paradox is the paradoxical injunction, “be sponta-
neous.” As soon as one attempts to act on this command, one cannot. It is only
when one gives up that one can behave spontaneously. The most common form
of the pragmatic paradox or therapeutic paradox is to prescribe the symptom—in
other words, to encourage the client to become even more symptomatic. (p. 5)

And here is a typical paradoxical therapy technique used with the common
complaint of anxiety.

A client who was anxious and worried chronically was told to set aside one hour
a day to worry. She was told she worried constantly because she had always
avoided thinking about troubling matters, and consequently never made any
changes. She was further told that she would have to become a competent wor-
rier if she could ever hope to resolve her anxieties. Effective worrying meant
she had to think the worst possible thoughts and keep a list of everything that
might worry her for her “worry time.” Moreover, she was told to worry the full
hour even if she felt like stopping early. (p. 121)

Weeks and L’Abate report that the client found the first couple of days of
this exercise painful in that the worrying increased. However, after just a few
days she found the assignment onerous and boring and wanted to cut it short.
Finally, she reported that she was no longer worried and had decided that all
that worrying she used to do was absurd.
Like Farrelly, Weeks and L’Abate got good results with paradoxical tech-
niques. Unfortunately when used by less gifted therapists, the results were
mixed at best. Many clients found the approach insulting, others failed to
understand it, still others agreed to try practicing it at home but failed to follow
through. Paradoxical therapy is always Dionysian and, when employed cor-
rectly, typically generates an altered state. Generating altered states is always
somewhat of a gamble—a gamble between succeeding and supercharging
the technique and failing and being perceived as an eccentric, strange, and
confused therapist. Less charismatic therapists avoided paradoxical therapy,
 Wizards among Us 177

especially if they failed in their first few tries. As a result, despite the impres-
sive stories from Farrelly and Weeks and L’Abate, it never gained the popu-
larity of more Apollonian techniques such as CBT.
CBT and other Apollonian techniques do not require altered states. They
are not supercharged in the same way that paradox or hypnosis is super-
charged. In that sense, they are safer albeit less powerful. If a CBT therapist
fails to engage the client, he is simply seen as boring or detached or a poor
listener. He is not reviled as an eccentric wacko.
Farrelly succeeded for the same reasons Erickson succeeded: an abundance
of charisma. Farrelly’s explanations—which were in part responsible for the
brief popularity of paradoxical techniques—failed to ensure replication of
his results. This failure to replicate is the standard outcome when average
therapists believe they can achieve the outcomes of the wizards by copying
their techniques. At the end of the day, these failures are always due to a
confabulation of fundamental reality with constructed reality.

WIZARDS AND ALTERED STATES

If the doors of perception were cleansed, everything would appear to

man as it is: infinite.
—William Blake, “A Memorable Fancy,”
The Marriage of Heaven and Hell (1790–1793)

There is a deep and inevitable connection between therapeutic wizards and

altered states. If you are a key individual who is recognized by others as
empowered to define reality, wouldn’t it behoove you to supercharge your
rituals with altered states to ensure that your clients change more profoundly
with each encounter? From another perspective, simply the act of quickly
and profoundly rearranging the strands of one’s Net at the direction of a key
individual is, in itself, an altered state. Any way you look at it, therapeutic
wizards are always associated with altered states.
Constructionists have done interesting and insightful work demonstrating
just how fragile the collective Net is for each of us. In fact, the Net is so frag-
ile that we are constrained to reinforce it constantly via tightly defining many
of our social interactions. In the following examples, students are asked to
disrupt this constant level of support and thereby reveal how easily the Net
can unravel.

The importance of the continuity of everyday routine is well exemplified in

Harold Garfinkel’s (1963; 1967) experiments with everyday conversation. Gar-
finkel asked his students to monitor their friends’ and relatives’ reactions when
178 Chapter 8

taken-for-granted ways of conversation were suddenly called into question by

the student conducting the experiment.
(Here is a carpool member telling the student) about having had a flat tire while
going to work the previous day.
Carpool member: I had a flat tire.
Student: what you mean, you “had a flat tire?”
Carpool member: (momentarily stunned, replies hastily) what you mean, “what do
you mean?” A flat tire is a flat tire. That is what I meant. Nothing special. What a
crazy question.
(In a second case) the victim waved his hand cheerily.
Acquaintance: how are you?
Student: how am I in regard to what? My health, my finances, my schoolwork, my
peace of mind, my . . . ?
Acquaintance: (red in the face and out of control) look! I was just trying to be
polite. Frankly, I don’t give a damn how you are. (Hjelm, 2014, pp. 28–29)

Note that in these examples, the subjects responded with some level of
aggression. To understand these responses, imagine what kind of person
steps outside the well-recognized boundaries of conventions, politeness,
and expectations. The first category would consist of children, disabled
people and strangers from another culture. By and large, when these people
violate conventions they are dismissed as individuals of insignificant status
and knowledge and their behaviors are essentially ignored or corrected. The
second category, illustrated in these examples, occurs when peers who are
acculturated respond atypically. The assumption here is that they are teasing
or taunting and the common response is aggression and/or intimidation.
The aggression has a double meaning, however. The first meaning is “stop
taunting me.” The second meaning, and probably the more important one
from the point of view of the experiment, is “stop unravelling/destroying my
world.” This sense of how quickly reality unravels, and how aggressively
individuals operate to stop “unravelling” behaviors, is helpful to witness for
Reality B therapists. Anything that demonstrates how the seemingly solid is
one interaction away from becoming fluid and chaotic encourages therapists
who are oriented toward change and growth.
In the Farrelly examples above, he was a high status person both by defini-
tion—he was a professional—but even more so by behavior and nonverbals:
Farrelly had learned to conduct himself so that others perceived him as an
authority figure. In addition, Farrelly had also developed the ability to project
caring and compassion to others; he was not simply high status, his clients
also had the feeling that his behaviors were emitted with the purpose of help-
ing others. In the examples above, Farrelly generated words and behaviors
 Wizards among Us 179

that significantly violated cultural norms. And, as he emphasized, these

cultural norm violations were emitted in the context of a caring relationship.
Finally, he clearly intended to violate the norms in the hope that unraveling
the client’s sense of a solid identity would facilitate change. In the vignette
above, Farrelly’s subtle guidance allowed the client to recover from her
altered state and return with a sense of resolve.
Note that the first response of his clients was confusion. Those familiar
with Ericksonian Therapy will immediately remember Erickson’s repeated
emphasis on “confusion technique” as an important adjunct to therapy. Steve
de Shazer (1985) points out that the confusion technique is used to shake
clients out of a restricted state of consciousness.

[M]y confusion technique is a development of Erickson’s work. . . . While

Erickson’s technique was developed in an experimental setting, he did use
it in hypnotherapy with individual patients “desperately seeking therapy but
restricted and dominated by their clinical problem.” (p. 9)

In the classic Ericksonian definition the confusion technique consists of con-

tradictory, inconsistent, and irrational statements in trance which served to
deepen trance. The confusion technique works because the client becomes
uneasy when the high status person—the therapist—unweaves the social fab-
ric by emitting a series of statements that no one can decipher. Obviously the
client can choose to discount the therapist as crazy or foolish at that moment.
However, when the therapist is a high status person, the client takes the sec-
ond option and decides to believe the fault is somehow with him. He becomes
anxious and chooses to do something to please the therapist. Since the thera-
pist is hypnotizing him, he pleases the therapist by going deeper into trance.
De Shazer (1985) points out that it can be used outside of trance as well.

While Erickson’s technique involves the therapist using highly complex verbal
skills and ambiguity in meaning, mine involves exploring in detail each and
every possible point of difference between the two people without any attempt
at closure or resolution and then openly admitting my confusion in the face of
their confusion. In either case, the idea is that the therapist develops rapport and
cooperation through utilizing the client confusion in such a way that the client’s
need to construct meaning in the therapy situation is frustrated and thus the
setting of a goal, which gives the situation meaning, is necessitated. (pp. 9–10)

In this example, the therapist analyzes the couple’s interactions carefully and
professionally. Then, strangely enough, he openly declares his impotence and
incompetence. The client is confused by this contradiction and tries to resolve
the confusion state by doing something to please the high status therapist;
in this case they are required to set a goal that gives the situation meaning.
180 Chapter 8

Put another way: the best way to flee the uncomfortable and confusing
situation is to leap to a solution to the presenting problem. In summary, the
confusion technique exists whenever a high status person operates out of the
bounds of acculturated expectations. Especially when this occurs in the con-
text of a caring relationship, the client has a tendency to resolve the confusion
by feeling and acting in accordance with the implicit or explicit expectations
of the therapist.
Frankly, if even the explanation sounds confusing, you’re in good com-
pany. Confusion techniques are like lots of techniques employed by thera-
peutic wizards; they work great when they perform them and are mediocre or
ineffective when the average therapist tries to replicate them.
Now, suppose you are a high status therapist who can also project a sense
of caring and connection. You would discover that virtually anything you did
would result in the client attempting to please you. Moreover, if you instill
confusion by operating outside the bounds of cultural expectations, you
would tend to see rapid client change as they become hyper motivated to do
whatever is necessary to return the world to a solid and comfortable state. If
you have this “therapeutic wizard” power, it gives a whole new meaning to
beginners mind. When Erickson says (as quoted in the preceding chapter), “ I
always invent a new treatment in accord with the individual personality,” he
is literally recording his experience that pretty much anything he does—given
his status, warmth, and willingness to operate outside of convention—will
work with most clients. Similarly, when Farrelly recommends that “The
expression of therapeutic hate and joyful sadism toward clients can markedly
benefit the client,” he is recording his experiences as he moves through the
therapeutic environment. In the quote below, de Shazer provides a different
angle on the experience, “everything I do seems to work.”

For an intervention to successfully fit, it is not necessary to have detailed knowl-

edge of the complaint. It is not necessary even to be able to construct with any
rigor how the trouble is maintained in order to prompt solution. Given all of my
previous work, this at first seemed counter-intuitive, but it does seem that any
really different behavior in a problematic situation can be enough to prompt
solution and give the client the satisfaction he seeks from therapy. All that is
necessary is that the person involved in a troublesome situation does something
different, even if that behavior is seemingly irrational, certainly irrelevant, obvi-
ously bizarre, or humorous. (1985, p. 7, italics in original)

Note how perfectly de Shazer makes the Reality B case. He says that know-
ing the past and/or the details of the case are not important. All one needs
to do is generate any different response, preferably one which is unexpected
and outside cultural norms. Of course, what de Shazer leaves out is that
such situations are only resolved positively—in the direction of therapeutic
 Wizards among Us 181

healing—if the client is motivated to resolve her “confusion state” in a man-

ner that pleases the high status, compassionate therapist.

CLIENT POWER

[N]ever try to follow another’s path for that is his way, not yours.
When that path is found, you have nothing to do but fold your arms
and the tide will carry you to freedom.
—Swami Vivekananda, The Complete Works
of Swami Vivekananda (1907)

The emphasis in this chapter is on the power of the therapeutic wizard. While
that is appropriate in a book focused on increasing therapeutic efficacy via
enhancing charisma, it is always vital to remember the centrality of the client
in the therapeutic process. While the proceeding few sections may make it
appear that a wizard can move effortlessly through the therapeutic environ-
ment making changes with a “wave of her mind”—and indeed that is literally
what this chapter argues—it is simultaneously and paradoxically true that all
of these changes are completely dependent on connection with and feedback
from the client.
Scott Miller and many of his colleagues have argued that psychology needs
to deemphasize techniques and focus on enhancing the therapist. However,
his emphasis on therapist enhancement is client centered. Miller (2007)
points out that client factors are vastly more important than therapist factors
in determining outcome and suggests that the best road forward is to develop
practices—such as formal feedback mechanisms—that explicitly focus the
therapist on client feedback. He notes that most therapists report that they
prioritize client feedback; however, Miller believes that in actual practice,
they miss many cues. In response, Miller has developed his own approach to
therapy—Feedback Informed Treatment—to specifically redress this issue.
This chapter, of course, is about therapeutic wizards; these wizards, of
course, operate at the highest level of functioning. In this sense, they are not
only capable of being recognized as key individuals and superb at creating
Dionysian experiences, they are also expert at reading and responding to cli-
ent feedback. Obviously there are many ways to become expert at incorporat-
ing feedback; we will highlight one particular approach that is derived from
hypnotherapy.
It can be argued that hypnotherapy is the one of the best training models
in terms of learning to read clients’ nonverbal cues. Trance inductions and
trance deepenings are completely dependent on pacing the client’s current
experience and leading them toward an altered state. When the therapist fails
182 Chapter 8

to read the client effectively, this process fails. This kind of immediate and
drastic feedback enhances therapist awareness and connection skills.
In this sense, some of the most useful work on reading clients has been done
by hypnotherapists. In the Ericksonian model, this kind of client “reading” is
called the utilization approach. The concept of utilization developed out of
hypnotherapy and its earliest definition was something like “use whatever the
client is currently doing as the basis of a trance induction.” For example, if a
client blinks during an induction, the therapist might say, “you’ll notice that
your eyes have a tendency to blink on their own and with every blink, it gets
a little harder for the eyes to stay open.” As you notice the breathing slowing
and quieting, the therapist might say, “as you relax, your breathing slows and
with every exhalation you find more and more tension leaving the body.” As
the person becomes more still, “the body becomes quieter and quieter and
you find yourself sinking deeper into the chair. You notice your limbs becom-
ing heavier as if it were impossible to move them.” Noticing the nonverbal
allows the therapist to comment on them. Correctly describing them allows
the therapist to suggest moving deeper and deeper into a trance state.
Ericksonians build on this literal ability to work with feedback in trance
introduction and extend it into an awareness of client feedback in every
aspect of therapy. The following two quotes—the first by F. William Hanley
and the second by Stephen Gilligan—explain the extension of the utilization
approach into traditional verbal therapy.

Erickson was prepared to use any behavior that the patient offered in working
toward the therapeutic goal for the patient. “In rendering aid, there should be
full respect for, and utilization of, whatever the patient presents.” Every mani-
fest behavior, every psychological state, understanding, attitude, and resistance
that the patient brings into the situation has a positive potential and can be used,
wholly or modified, to lead to new, more adequate behavior. This is done by
introducing new ideas (changing perception and meaning). For example, a cut
on the lip of a child can become a source of satisfaction and even of prestige
because of the number of stitches it requires. (Hanley, 1982, pp. 31–32)

Gilligan continues,

[Y]ou take what the person gives you and use it. That becomes your strategy.
One of the profound consequences of this way of thinking and acting is that
there really is no such thing as “resistance” in a utilization approach. Every-
thing the person is doing is exactly what you would like him to be doing. Your
task is to generate communications that use ongoing experiences. When you
are not fully using them, the subject will tell you, usually indirectly and nonver-
bally. You will find yourself accusing the person of being “resistant” or brand-
ing him\her as “non-susceptible.” You are reacting to communications from
 Wizards among Us 183

the subject that are saying, “what you’re doing is not pacing me at this time.
You’re not using some behavior or experience of mine.” Neither the hypnotist
nor the subject is a “bad person” or “wrong” or “sick” or “crazy.” “Resistance”
is just a message that you need to synchronize yourself with the subject again.
I think this is a radical concept that is incredibly useful to the clinician. (Gil-
ligan, 1982, p. 92)

Essentially these two quotes extend the utilization approach from a method
of trance induction to a method of observing and then working with every
communication—verbal and nonverbal—emitted by the client. The therapist
practicing utilization is not delivering a lecture about rational versus irrational
cognitions or the dangers of enmeshment; rather, everything they say and
do is tightly intertwined with the last message from the client. The therapist
attention remains focused on the client. And in this sense, the client’s current
state in large part guides the therapeutic process.
The fundamental benefit of the utilization approach, of course, is that with
an awareness of active feedback the therapist can modify her approach until
it achieves client resonance. Whether one is a therapeutic wizard or simply
an average therapist, the Frank model is clear that every therapeutic ritual
requires client concurrence. Wizards have more power than the rest of us and
that power allows them to influence clients in ways unavailable to the aver-
age practitioner. But we should recall that charisma is equal parts wisdom
and connection. This implies that the power of the wizards comes both from
the client recognizing the wizard as a key individual with unique authority
and from the wizard being uniquely capable of reading and responding to
the client. At the end of the day, these expressive and receptive gifts unite as
one. Even the most charismatic therapist will be quick to note that her actual
power is completely dependent on her ability to read, respond and defer to
the essential client message.

MAPPING AND MODELING

How many legs does a dog have if you call the tail a leg? Four.
Calling a tail a leg doesn’t make it a leg.
—Abraham Lincoln, Reminiscences of Abraham
Lincoln by Distinguished Men of His Time (1886)

The most natural response to a therapeutic wizard is the attempt to understand

what they are doing so that we can emulate them. Unfortunately, this wish
to map the wizards runs into a simple problem; if we are trying to map them
in fundamental reality and they are actually operating in constructed reality,
184 Chapter 8

we’re going to have some difficulties. As de Shazer (1985) discusses below,

this mapping process has encountered the predictable obstacles.

Starting with Haley and Weakland’s efforts, Erickson’s work has been mapped
in great detail by many map-makers, using a wide variety of map-making tools.
It is tempting to think of the process as progressive and cumulative, map 2 being
an improvement on map 1, and map 3 an improvement on both. However, as
Kuhn has pointed out, this is not always the case, particularly during a paradigm
shift. The degree of fit between or among the many maps may stop at a very
broad and abstract level: This map is a map of Erickson’s work. For instance,
a glance at Haley’s and Weakland’s maps, Bandler and Grinder’s maps and de
Shazer’s maps might lead the reader to wonder if the same territory is being
mapped after all. (p. 49)

This level of confusion is an expected result if the actual law of constructed

reality is: “a high status, caring person can do virtually anything and it will
work.” The map makers are trying to create Reality A-type maps that can
be used by normal therapists—therapists with normal status and a normal
capacity for relationship. Maps and the mapping process are essentially
Apollonian; these are attempts to outline the complex machine-like processes
that underlie fundamental reality. The hope is that the maps will lead to tech-
niques which possess their own implicit power and which can be replicated
by any trained person.
Unfortunately, constructed reality is resistant to mapping. Reality B change
is dependent on co-created rituals that are fluid and malleable. Change occurs
through passage through meaningful experiences. Put another way, while it
appears that wizards are using techniques in therapy, they are, in fact, doing
nothing of the kind. In sum, the search for a map that describes Farrelly or
Erickson or de Shazer so effectively that an average therapist can achieve
their results is doomed to failure. No techniques can be derived. These master
therapists literally shape reality with their will and their interventions. They
are not using techniques that can be replicated by normal therapists. This is
Reality B, not Reality A.
We have already discussed the fact that wizards often break the rules dur-
ing normal therapeutic interactions. Many of them also break social rules
outside of the therapy room. For example, Erickson often dressed in all purple
clothing and it was explained that this unusual attire was somehow related to
his colorblindness. This ability to mark oneself as outside the norm is often
found in shamanic healers and therapeutic wizards. Bill Maher often makes
humorous references such as “the difference between you and a holy man is
that he wears a pointy hat.” Maher’s belief is that the pointy hat is no guar-
antee of spiritual authority and, of course, he is literally correct. But when
one reviews the lifestyle choices between a charismatic figure like Truman
 Wizards among Us 185

Capote and a normal person, it is clear that wizards often break the rules in
more ways than simply peculiar conduct in the room.
These outer signs are attempts to mark the wizard as an emissary from
“sacred space”—a person who no longer dwells in the conventional world—
a visitor from another reality. This is well illustrated by a scene from the
movie, The Matrix. In this particular scene, the mentor figure, Morpheus, is
teaching the beginner, Neo, about his powers and limitations in the Matrix.
He explains that the Matrix is an interactive computer program which is
so seductive and compelling that, when you are inside it, it cannot be dis-
tinguished from reality. However, because it is a program—and not real-
ity—humans who understand and accept that they are in a program will have
extra powers and potentialities. As the dialog evolves note that Morpheus
moves from an instructional role to a more active, exhortation-type role. He
repeatedly admonishes Neo to relinquish the sense that he is constrained and
limited. The dialog occurs in the context of a martial arts encounter.

Morpheus: This is a sparring program, similar to the programmed reality of the

Matrix. It has the same basic rules, rules like gravity. What you must learn is that
these rules are no different that the rules of a computer system. Some of them can
be bent. Others can be broken. Understand? Then hit me, if you can.
(Morpheus defeats Neo in the first round)
Morpheus: How did I beat you?
Neo: You’re too fast.
Morpheus: Do you believe that my being stronger or faster has anything to do
with my muscles in this place? You think that’s air you’re breathing now? Hah . . .
Morpheus: What are you waiting for? You’re faster than this. Don’t think you are,
know you are. Come on. Stop trying to hit me and hit me.
Neo: I know what you’re trying to do.
Morpheus: I’m trying to free your mind, Neo, but I can only show you the door,
you’re the one that has to walk through it. (Silver, Wachowski & Wachowski, 1999)

This is the fundamental challenge that constructionism offers therapists: can

we let loose of the limitations on our minds established by prior program-
ming? Fully absorbing this concept allows the therapist to create new realities
with the “wave of her mind” subject only to the concurrence of the client.
Constructionism offers therapists the opportunity to be free from the normal
restrictions of programmed reality: “Some rules can be bent. Others can be
broken. . . .” The key is to let go of preconceptions and all one has learned
about limitations.
The second implication from the Matrix example reinforces the idea
that clients do not change by techniques or psychological principles that
have been discovered: “Do you believe that my being stronger or faster has
anything to do with my muscles in this place? You think that’s air you’re
186 Chapter 8

breathing now? Hah. . . .” It is important to understand that techniques

never create new realities. New realities are created out of whole cloth by a
respected person—the therapist—and validated by the agreement of the cli-
ent. Techniques and interventions are simply the dialog that occurs between
therapist and client as they are co-creating a new reality. They are vehicles
that carry the intentions of the therapist to the client and vice versa—vehicles
that are credible and acceptable.
Returning to our process of mapping and modeling, we know the wizards
are charismatic—key individuals who are recognized as having the power
to define reality. This recognition arises from their acceptance—like Mor-
pheus—that they are strangers in the conventional world and that they have
been given/earned the ability to bend some rules and break others. They can
be recognized by their ability to flout conventional rules, inwardly and some-
times outwardly, their abilities to cultivate altered states, and their superb
capacities to connect to and read the client. Finally, they have a relentless
optimism about the possibility of change and often seem to ignore limiting
factors that daunt the rest of us—factors such as history and the presence of
trauma, and self-destructive behaviors.
These, then, are the aspects we are attempting to model. Being distracted
by techniques distilled by map makers—or even being distracted by tech-
niques recommended by the wizards themselves—will slow down the model-
ing process.
Arguing that even the wizards are incapable of explaining what they do
is certainly a peculiar thought. Simply because the wizards have learned to
be effective does not imply that they know the basis for their own effec-
tiveness. Every brilliant artist is not necessarily capable of describing the
essence of how to be a brilliant artist. This is particularly true because
every wizard is not necessarily aware of the difference between constructed
and fundamental reality. In the example above from the Matrix, Morpheus
knows this difference and is trying to teach it directly to Neo. But other
masters, however accomplished in practice, fail to achieve that level of
conscious awareness.
Thirty years ago, as a beginning psychologist, I was attempting to learn
from and model myself after the wizards. At that point in my career I still
believed in techniques and in training workshops. Fortunately for me, prior to
studying and becoming a psychologist, I had been exposed to a vast amount
of Eastern thought and been particularly attracted to the constructionism that
lies at its core. I had also formally studied the phenomenology of religion
which also included a great deal of constructionism as well as emphasizing
a method of study embodied by the phrase “the thing in itself.” One of the
primary concepts in phenomenology is to simply describe something and
show up for that without putting too many preconceived frames around it.
 Wizards among Us 187

Of course, such a practice is impossible to do perfectly but it pushed me in

the right direction and dovetailed nicely with my training in constructionism.
In the following example I attempt to replicate some of the qualities I had
studied in the wizards. In a formal sense, what I did with the client might be
labeled paradoxical therapy or perhaps ordeal therapy1. In truth, what I feel
I was attempting to do was to encounter a client without focusing much on
history, trauma, or resistance. Put most basically, I was attempting to change
him via a simple request.

A 34-year-old presented with complaints of excessive shyness around dating.

He confessed that although he was successful in his profession career, and was
reasonably attractive, he was so shy around women that he had never had a date
and he was a virgin. His goal in therapy was to be able to date women and, ide-
ally, have a first sexual experience.
I decided to prescribe an ordeal. I explained that his problem was that he
had an excessive fear of rejection which he could cure by placing himself in
a situation where he was bound to be rejected. He lived near a resort town
and I told him to go to the most upscale bar in that town and ask the pret-
tiest women to dance. I predicted that he would be rejected fairly often and
asked him to meditate in exquisite detail on how he made these rejections
unbearable.
He returned the next week and said that he had only been rejected a few times
and didn’t feel that his dancing experiences or his meditations on rejection had
accomplished much. I replied that we needed to “up the ante” and asked him
to stand outside of a coffee shop in his home town and ask every attractive
woman to come inside and share a cup of coffee with him because she “looked
interesting.” He seemed appalled by this directive and left the session with a
worried look.
Next week he returned with a different look on his face. He told me that he
had gone home with lots of ambivalence about his assignment. Instead of com-
pleting it, he had decided to ask a woman out at work. He had seen her three
times since the last session and, on their last date, he had had sex with her.

This is a simple and straightforward example of ordeal therapy (Haley, 1993).

In ordeal therapy, the therapist prescribes an ordeal with an implicit message
that they can either do the ordeal or choose to resolve the presenting problem.
In this case, the client needed to perform the coffee shop ordeal or make the
ordeal unnecessary by dating a woman. Analyzing the vignette, it appears as
if the prescribed ordeal had something to do with the outcome, particularly
because the client eventually explains his success as an attempt to avoid the
ordeal.
In reality, of course, the ordeal had little to do with the successful thera-
peutic resolution of the case. If the client had not perceived me as a relatively
high status therapist who was genuinely invested in him getting better, he
188 Chapter 8

could easily have decided that my prescription was a silly idea and simply
disregarded it. That is, in fact, what often happens when attempting to pre-
scribe an ordeal. The client simply ignores the intervention and the sessions
involved are more or less wasted. This case example could also be called
paradoxical therapy in that I prescribed the symptom. Farrelly might have
called it Provocative Therapy since I went into great detail about how pretty
the women were in the resort town and how likely it was that they would
reject him given his modest appearance.
I saw it at the time as an example of how easily people change. It seemed
to me that all the techniques I was using were beginning to blur together. I
think this insight was facilitated not only by my study of constructionism but
also because I had recently completed a dissertation evaluating the efficacy
of a certain neurolinguistic programming (NLP) technique. In the disserta-
tion, I had to perform the same technique over and again multiple times. As
I attempted to adjust the technique to meet client needs, the protocol started
varying significantly from case to case. I began to believe that the outcome
was much more dependent on whether the client saw me as effective versus
whether I had performed the technique well.
Now I know I wasn’t using a constructionist model perfectly—I still
believed I was doing a technique. But every time I looked at the wizards and
their work closely, I believed in the power of techniques less and less. Every
time I saw a traumatized or treatment resistant client change without much
fuss, the less I believed in the importance of history. My own work seemed to
be pushing me in the same direction; my charisma felt vastly more significant
than the techniques. Moreover, the more I learned new techniques, the more
they seemed to be variations on each other.
Returning to this specific client: it should be emphasized that he was actu-
ally quite anxious and certainly reported that he felt full of shame, guilt, and
embarrassment. He felt terrible about being a virgin and had never had one
real date. These feelings were exacerbated by his age and the fact that he lived
in a resort town where everyone came to party. Moreover, he had a reason-
able social life and participated in many activities each month. He was always
wondering what was wrong with him. For me, it was tempting to explore his
past and find out what kind of trauma or misconstruals might have led to his
restricted sexual functioning.
When he resolved the issue in only two sessions, as a relatively new thera-
pist I, of course, felt proud of my success; maybe this new career was going
to work out after all. But more important than the ego gratification, was the
sense that something different was going on. The more I practiced, the more I
felt the presence of some kind of anomaly; the models of change I had learned
weren’t really fitting my experience. All my studies, and the particular results
of this case, were piquing my curiosity. Something different was occurring
 Wizards among Us 189

here. The world seemed more fluid than I had been led to believe and for me,
the door had opened to what Kuhn calls the “awareness of anomaly.”

Scientific development depends in part on a process of non-incremental or revolu-

tionary change. Some revolutions are large, like those associated with the names
of Copernicus, Newton, or Darwin, but most are much smaller, like the discovery
of oxygen or the planet Uranus. The usual prelude to changes of this sort is, I
believed, the awareness of anomaly, of an occurrence or set of occurrences that
does not fit existing ways of ordering phenomena. The changes that result there-
fore require “putting on a different kind of thinking-cap,” one that renders the
anomalous lawlike but that, in the process, also transforms the order exhibited by
some other phenomena, previously unproblematic. (Kuhn, 1977, p. xvii)

NOTE

1. In ordeal therapy the client is required to choose between two alternatives: the
healthy option and an “ordeal” that they must complete if they refuse the healthy
option.
 Chapter 9

Apollonian Power
The Primacy of the Conscious Mind

If it is not right do not do it; if it is not true do not say it.

—Marcus Aurelius, Little Classics (1912)

The Net is a wondrous thing. And the Apollonian forces that maintain it
are serving everyone in the culture. This is a book about change; hence, the
Dionysian is emphasized and the Apollonian is implicitly criticized for its
conservative and stabilizing biases. But it should be clear that the Net is nec-
essary to raise children, to enable society to have shape and stability, and to
create individual continuity. In addition it provides a hundred other services
without which human community would be impossible.
Just as there are therapeutic approaches that are primarily Dionysian, there
are other approaches that are primarily Apollonian. The following light bulb
joke discusses some of the differences.

Q: How many Constructionists does it take to change a light bulb?

A: At least ten, as they need to hold a debate on whether or not the light bulb
exists. Even if they can agree upon the existence of the light bulb they still may
not change it to keep from alienating those who might use other forms of light.
Q: How many Apollonians does it take to change a light bulb?
A: CHANGE??

Joking aside, of course Apollonians are committed to change, just as long as

the change consists of a safe developmental path that is congruent with the
existing culture’s Net. Often this takes the form of moving successfully to the
next level of life: the teen becoming an adult, the single person succeeding at
marriage, and so on. In this sense, it can be argued that most human change
is Apollonian change and the majority of clients who present are either
191
192 Chapter 9

befuddled with Apollonian issues, have had trouble achieving full member-
ship in the culture (e.g., young adults who are failing the adolescent/adult
transition), or individuals who have been overwhelmed by a breakthrough of
the Abyss (e.g., divorce, health problems, loss). In sum, while it may be vital
for the therapist to be comfortable with Dionysian principles and courageous
and skilled when it comes to encountering the Abyss, the majority of the
clients will be operating within the Net and focused on Apollonian develop-
mental concerns.
There are a number of therapies which can be characterized as Apollo-
nian but it is more useful to think that there is an Apollonian or Dionysian
approach to every therapeutic intervention. For example, hypnotherapy, a
profoundly Dionysian therapy emphasizing altered states, can be done in an
Apollonian manner.

You’re getting sleepier and sleepier and your eyes are closing sending you into
a deep trance where you can only hear the sound of my voice. Next time you
take a drag on a cigarette, it’s going to taste like camel dung and you will have
a vision of your lungs turning black and becoming cancerous.

In this sense, regardless of the natural tendency of any therapy to be Apol-

lonian or Dionysian, the difference is more in the approach than the actual
qualities of the technique. However there is one particular area where there
is a consistent difference between the two: how they deal with the hierarchy
between conscious and unconscious processes.
The first challenge of psychotherapy is how to help individuals control
feelings, compulsions, and misconstruals that appear to be autonomous—
unconscious material that invades and disorganizes our lives. This is the
primary task of the Apollonian therapies: helping the individual regulate
affect and all the autonomous psychological processes so that he can func-
tion as a healthy citizen, family member, and individual. More Dionysian
therapies might discuss cooperating with the unconscious, or working with
the shadow, or experiencing the transformative nature of sacred space. Apol-
lonian therapies focus on simple self-mastery and especially on the kind of
self-mastery that facilitates accomplishing culturally validated goals and
success experiences.
Apollonian approaches are, of course, deeply grounded in the prevailing
cultural Net. To be Apollonian implies a sense of right and wrong and good/
bad; hence Apollonian therapists are more authoritarian and directive. Com-
pared to a Dionysian therapist, an Apollonian feels empowered to instruct a
client, to direct her, and to use her own sense of guilt and shame as a motiva-
tor. To understand how this plays out in real time, examine a classic Apol-
lonian therapy, reality therapy.
 Apollonian Power 193

In 1965 William Glasser wrote a small but important book entitled Reality
Therapy. The system presented therein is deceptively simple but has profound
implications for how people change and the usefulness of extant therapeutic
maps. His ideas were especially creative and innovative fifty years ago when
most therapy was still dominated by psychodynamic ideas and concepts.
Here are his basic principles: first, like Farrelly, Glasser (1965) neither
believes in the concept of mental illness nor the unconscious mind; moreover,
he does not feel that it is useful to explore the client’s past.

Because we do not accept the concept of mental illness, the patient cannot
become involved with us as a mentally ill person who has no responsibility for
his behavior.
Working in the present and toward the future, we do not get involved with
the patient’s history because we can neither change what happened to him nor
accept the fact that he is limited by his past.
We do not look for unconscious conflicts or the reasons for them. A patient
cannot become involved with us by excusing his behavior on the basis of uncon-
scious motivations. (p. 44)

In place of old assumptions about mental illness and the importance of the
past, Glasser proposes that a meaningful relationship with a responsible per-
son can lead to healing and positive change. The essence of reality therapy is
that a patient should begin from where he currently stands, examine the pros
and cons of his situation, and then make effective plans that result in meet-
ing his needs in the future. This is accomplished by straightforward, logical
discussions with the therapist, who needs to be both a responsible person in
his own right and someone who has formed a significant relationship with
the client. Finally, the emphasis is on behavioral changes not ideas, feelings,
and trauma.

We emphasize the morality of behavior. We face the issue of right and wrong
which we believe solidifies the involvement, in contrast to conventional psy-
chiatrists who do not make the distinction between right and wrong, feeling it
would be detrimental to attaining the transference relationship they seek.
We teach patients better ways to fulfill their needs. The proper involvement
will not be maintained unless the patient has helped define more satisfactory
patterns of behavior. Conventional therapists did not feel that teaching better
behavior is part of therapy. (1965, pp. 44–45)

Finally, the reality of the patient’s current situation is examined not only from
the standpoint of right and wrong, but also from the standpoint of workable
or dysfunctional. Reality therapists are quick to question the client’s feelings,
cognitions, and plans in terms of: “Will this get you where you want to go?”
194 Chapter 9

and “you’re not accepting the truth of how things work here.” Following is a
typical reality therapy case.

Sent to us as the last resort, she was a pretty but extremely tense 16-year-old who,
when I first saw her, demanded that I do something to make her less nervous. She
evidently had been taking a variety of different tranquilizer drugs at the previ-
ous institution, and even before I took her into therapy she cornered me in her
cottage where I was eating lunch and demanded medication for her nerves. With
the demand she gave me a lecture on the varieties and activities of tranquilizer
drugs that would’ve been a model for a pharmacologist. I refused, explaining that
no tranquilizers of any kind were used at Ventura because I did not believe they
help the girls. Tranquilizers help people escape from facing reality; they should
only be given to people who are in good control or to those who are so far out
of control that they need physical restraints, such as a violent patient in a mental
hospital who may need cuffs. We have neither type of girl at Ventura. I told her
that I was the only person who could prescribe tranquilizers so that throwing a
tantrum for someone else would not help. I explained that if she thought acting
upset would get me to prescribe tranquilizers, now was her chance. She could
throw her best tantrum and I would be glad to sit with her and we would discuss
it, but there was nothing in terms of bad behavior that I hadn’t seen 1000 times
previously and I had long since given up prescribing drugs for temper outbursts.
My remarks surprised her greatly. Previously, professional people had
responded to her nervousness and threats of acting out by unwittingly, but from
her viewpoint solicitously, relieving her of the responsibility for her behavior
with large doses of tranquilizer drugs. As she continued to threaten to break
windows and fall apart from nervous tension, I told her something that I believe
started our involvement.
“Terri,” I said, “Ventura is different from any other place you have been.
Here you have the right to suffer, and we will respect your suffering. You prob-
ably have good reason to feel bad, but you will not learn anything if we give you
pills. In fact, I’m sure that the more pills you received in the last institution, the
more you misbehaved and then blamed it on the pills. You do the same thing
yourself with liquor and reds and yellows (illegally obtained Seconal and Nem-
butal) when you’re at home, but you won’t be allowed to here.” Adding that I
would welcome her into my group therapy where I would help her find better
ways to behave so that she could feel better, I emphasized that in Ventura we
believe that what you do, more than what you feel, is important. I am not beyond
explaining reality therapy, in a sense, to the girls because they understand, more
than most of us, the truth in stressing behavior over feelings. She agreed, as have
countless other girls, that the pills increase their acting out by giving them an
excuse for it (they say their pills make them goofy so they can’t control them-
selves), and she never asked for them again. (Glasser, 1965, pp. 83–84)

Perhaps the single most striking aspect to reality therapy is its simplic-
ity. Fundamentally, it argues that all that is necessary to perform effective
 Apollonian Power 195

psychotherapy is to place a client in relationship with a caring and “respon-

sible” mentor who will help her face the dysfunctional nature of her current
choices and replace them with better plans and behaviors that lead her toward
actual need fulfillment. Reality therapy, of course, works as well as any other
form of therapy (Wubbolding, 2011). Moreover, I suspect that when Dr.
Glasser was the therapist, he achieved a level of effectiveness much higher
than the standard therapist.
Glasser is the archetypal Apollonian therapist. He is serious, motivated,
judgmental, confident, and somewhat intimidating. His goals have to do with
helping his clients meet their needs in the context of fulfilling successful roles
in the dominant culture. In this sense, he is likely to confront clients to face
or accept “reality” and to move forward in their life by playing by the rules
implicit in that reality.
Apollonian therapists are experts in the Net. In that sense, they not only
direct their clients to make choices that lead to success, they are also highly
aware of secondary gains. Glasser’s interactions with Terri around drug
seeking behavior is a good example. Apollonians would be just as direct and
forthright discussing getting off disability or the downsides of misbehaving
with authority figures.
Therapists who are cultivating the Apollonian will utilize both outer symbols
of success and power as well as inner attitudes of confidence and certainty.
Outer symbols include an upscale office, impressive diplomas on the walls,
expensive clothes and haircuts, and references to past associations with high
status people. Therapeutic recommendations are couched in terms of impres-
sive research. Better to be a doctor than a master’s degree therapist; better to be
an MD than a PhD; and better to be a psychopharmacologist than a psychiatrist.
Interventions are delivered with confidence and with more of a black and
white style. Doubts are refuted and ultimately destroyed. Glasser emphasized
the importance of the relationship but noted that the most helpful client-
therapist relationship often starts with the therapist telling the client the truth
about how confused they are in terms of their values or choices. “I care about
you enough to tell you the truth about how mixed up you are.” Moreover, the
charismatic Apollonian must have confidence that what they are recommend-
ing will, in fact, improve the lives and options of their clients.
Above all, the Apollonian therapist must be clear about her role as an
authority figure that represents the dominant culture. As an Apollonian, a
therapist is presenting herself as the power of the culture “made flesh” in
the form of a psychotherapist. The client needs to have the feeling that when
the therapist speaks, the entire culture is 100 percent behind the therapeutic
pronouncements. “Resistance is futile” is a phrase made famous by Star Trek
and the Borg; however, it is also the hallmark of the confidence projected by
the Apollonian therapist.
196 Chapter 9

When reality therapists are arguing that their effectiveness is due to

something beyond the therapeutic relationship, they are stating that they are
using the entire power of the culture and the internally programmed ideas of
“should,” “ought,” and right and wrong. To become an effective Apollonian,
to actually use reality therapy, a therapist must become comfortable with
being the embodiment of these kinds of concepts.

THE FEAR OF APOLLONIAN POWER

Be sure that you are right, and then go ahead.

—David Crockett, The Handbook of Illustrated Proverbs (1855)

The most controversial aspect of reality therapy and other Apollonian thera-
pies is the implicit hierarchy between therapist and client; the Apollonian
therapist accepts the hierarchy and uses it to achieve results. All of the con-
cepts like “right and wrong” and “good and bad” rest on the foundational
idea that “I know” and “you are confused” and you need to accept my help.
These assumptions can be problematic. It is easy to imagine a hundred
scenarios where the assumption of such power could go astray and injure the
client. Moreover, once one is comfortable with judgments, what is there to
keep the “confident” therapist from using coercion and force to impel that
client toward the desired goal?
A therapist cannot be an effective Apollonian without a foundational sense
of confidence in his own judgment. Yet such confidence flies in the face of
“client-centered therapy” and its implication that the power lies in the client
not in the therapist. Moreover, many therapists have a substantial percentage
of their clients who have been wounded by judgment. These clients come
into therapy filled with guilt and shame because they have failed to fulfill
family or cultural expectations. Is it right to “go Apollonian” and exacerbate
this shame by joining with those who have judged the client as lacking and
insufficient? Finally, one of the primary points of this book has been to pres-
ent constructionist arguments that document that all Apollonian worldviews
are arbitrary and invented. Knowing this, why would a therapist endorse a
worldview that she knows is ephemeral and constructed?
Conversely, there are just as many situations where the expert needs to
take control. A doctor coming upon a motor vehicle accident with significant
injuries is justified—nay, mandated—to take control, order helpers about,
and disregard feelings and other’s ideas in response to the needs of the emer-
gency. All therapists are mandated reporters when it comes to suicide and
participate in forcing clients into care against their will.
 Apollonian Power 197

The key, of course, is to determine when the situation is emergent, and

when a client is sufficiently disabled that the therapist has the moral right and
obligation to use whatever means available to force—or at least coerce—a
client in a certain direction. It is easy to judge the extremes and difficult to
judge the cases in the middle. The solution embraced by most therapists is a
relative one. The more evolved and mature the client, the more the therapist
defers to him. The more emergent, young, or disabled, the more the therapist
is comfortable assuming control.
Glasser is fine with this in principle, but he had so many experiences
where therapists were loath to take control when they should that he formally
designed reality therapy so that it would be easier for therapists to confront
and lead. In the following case—which Glasser credits as instrumental in the
formation of reality therapy—he is forced to explicitly reject psychodynamic
psychotherapy in order to use Apollonian power effectively. The case not
only documents reality therapy principles, it serves as a cautionary tale warn-
ing therapists that their excessive respect for client self-determination can
backfire and result in outcomes that actually hurt the client.
Apparently the boy in this case had had a number of psychodynamic
therapists before Glasser who had concentrated on making interpretations and
cultivating transference reactions. Glasser himself reported that his supervi-
sor urged him to continue on that same course. While Glasser began his
work with the boy with the intention of following that advice, the frustration
of working in that manner pushed him toward the Apollonian intervention
described below.

Aaron was the highly intelligent 11-year-old son of an unemotional, overly

intellectual divorced woman who worked as a mathematician at one of the
Los Angeles missile and space laboratories, and a father who lived in another
part of the country and had no contact with him. Aaron was often left home
in the care of the neighbor when his mother went away on weekends with her
boyfriend. At the time I saw him he had been seen by two other therapists
over the previous two years, both third-year resident in the psychiatric train-
ing facility. He was assigned to me for treatment when I was also a third-year
resident and was my first child outpatient. The other therapists had treated him
conventionally with play therapy. Most of their time was spent interpreting the
meaning of his play to him. For example, if he struck a female doll repeatedly,
the therapist would ask him if he wouldn’t like to hit his mother and hope
Aaron would confirm the truth of his guess. Having also been trained in tradi-
tional psychiatry, I attempted at first to follow in the footsteps of the previous
therapists. When Aaron confirmed his anger and hostility against his mother
I wondered, as they must have, why this insight did not help him. He wanted
to learn better ways to act, but up till then all of us had avoided teaching him
what he needed to know.
198 Chapter 9

One way to describe Aaron and his behavior is to say that although he was
pleasant in appearance, he was the most obnoxious child I have ever met.
I dreaded Monday and Thursday mornings because those days started with
Aaron. He had evidently been treated very permissively by his previous thera-
pists who, besides interpreting his behavior to him, accepted everything he did.
And what he did was horrible. He ran pell-mell from game to game and toy to
toy, never letting me help him to enjoy what he was doing. He seemed to be
almost desperately avoiding my offer to play as if my joining in the play might
deprive him in some way of some of his pleasures. He acted aggressively in a
completely haphazard, unpredictable way, crying for my attention but turning
nasty and withdrawing when I gave him some warmth. He discussed his mother
in a highly critical way, making her into an ogre of psychiatric rejection. . . .
He also rattled on about all the destructive things he did and was planning to
do at home.
He blamed his failure to be happy on his mother, her boyfriend, his missing
father, or his previous therapists. His school did not escape his critical wrath:
it was very bad, his teachers did not understand him, and the other kids picked
on him.
Regardless of how he behaved, no one had ever attempted to put a value
judgment on his behavior, no one had ever told him he was doing wrong. Every-
thing he did was accepted as something to be explained or, in psychiatric terms,
“interpreted” ad nauseum.
. . . It was some time before I began to realize that he was well aware of his
behavior, even to the extent that in his own erratic, impulsive way he devised
new tests for my patience. He actually planned some of his misconduct, which
must have been exhausting and difficult for him to keep up as long as he did.
His mother was an impersonal, detached individual who raised Aaron as an
object rather than a person. Instead of reacting to his behavior and setting some
limits, she discussed it with him objectively. Essentially a cold woman, she did
contribute to his frustration, but if our hope was for her to change, Aaron had
little chance. . . .
Although Aaron was desperate for some change, I was advised by my super-
visor to continue to work with him in play therapy and to interpret his “anal
retention and oral regression.” A firm believer in psychoanalytic theory, my
supervisor was convinced that the child needed to know “why.”
Although it was to be many years before reality therapy became definite in
my mind as a method of treatment, it was with Aaron that I first discovered the
dramatic force of confronting a child with present reality. This confrontation,
fortunately made after we had gained some involvement, solidified a relation-
ship into a deeper therapeutic involvement which produce great changes in
Aaron.
I realize dimly that in following the principles of orthodox therapy I was
contributing to Aaron’s present desperation rather than relieving it, and I made
up my mind to change my approach. Against all my training and reading, and
without telling anyone what I planned to do, I began a kind of reality therapy.
 Apollonian Power 199

The explaining was over. From now on we were going to emphasize reality and
present behavior.
When Aaron arrived the following morning I took him into my office, nudg-
ing him gently past the playroom when he tried to stop there as usual. Telling
him to sit down and listen, I explained that I wasn’t interested in anything he had
to say, only that he listens to me this morning. He whined and tried to get away,
but I held them and faced him toward me. I told him to shut up and for once in
his life to listen to what someone had to say. I informed him that the play was
over, that we would sit and talk in an adult fashion, or if we walked we would
walk as adults. I explained clearly that I would not tolerate any running away
or even any impolite behavior while we were walking. He would have to be
courteous and try to converse with me when I talked to him. He was to tell me
everything he did and I would help them decide whether it was right or wrong.
When he immediately attempted to leave, I forcibly restrained him. When
he tried to hit me, I told him I would hit him back! After two years without
restraint, it was probably the suddenness of this approach it shocked him into
going along with me. After some brief initial testing, he did not resist much,
probably because he had been anxious for so long to be treated in this realistic
way.
I wanted to know what he did in school and at home, and what he could do
that was better. When I told him frankly that he was the most miserable and
obnoxious child I have ever met, he was greatly surprised. He had thought all
therapists must automatically love their patients. I informed him that if he stayed
in therapy he was going to have to change because neither I nor anyone else
could possibly care for him the way he was now.
What happened next was most dramatic. First of all, he became likable,
talking to me courteously. He seemed to enjoy being with me and surprisingly
I began to look forward to seeing him. . . . Rapidly Aaron and I grew more
involved. Criticizing him for all his old weaknesses but praising him when he
did well, I stood in his path whenever he tried to revert to his old ways.
In about six weeks he changed remarkably. I heard from school that his work at
suddenly risen to straight A and that his behavior had also become excellent. The
teachers couldn’t understand what had happened. (Glasser, 1965, pp. 135–139)

In this case study, Glasser not only presents a masterful example of Apol-
lonian therapy, he also illustrates his own ability to deconstruct the imbedded
psychodynamic programming which was limiting his therapeutic effective-
ness. His frustration with Aaron’s lack of progress is palpable; it is easy to
feel Glasser chafing at the bit—impatient with the limitations imposed by the
psychodynamic approach. When he finally uses this frustration as a guide,
and gives in to his impulse to “go Apollonian,” his work takes on the vital
and powerful style so characteristic of this approach. Glasser becomes confi-
dent, confrontive, and fully prepared to instruct Aaron about what is right and
wrong, constructive and destructive.
200 Chapter 9

Effective Apollonian interventions are rooted in the therapist’s sense

that the client is capable of acting according to social norms and goals. It
is unlikely Glasser would have felt the frustration or used an Apollonian
approach if Aaron had a history of good behavior that only went downhill
after a head injury in an automobile accident. Glasser emphasizes that rapport
with the client is enhanced by confronting him about his inability to behave
well; implicit in the confrontation is the therapist’s belief that the client can
choose to behave well and that he is capable of being a full member of society
if he simply decides to adopt conventional values, choices, and aspirations.
And finally, Glasser is secure in the idea that it is both his duty and his obliga-
tion to impel his clients into a more effective relationship with society.
More specifically, depending on the evolution of the client, the most
important goal in his current life might be to join the dominant culture, move
up to the next developmental stage or fulfill his social role more successfully.
Statements such as “he needs to be a better father if he is going to get over
his guilt,” or “she needs to take a risk and have a success if she is going to
make her life work,” or “he needs to stop using cocaine if he wants to keep
his marriage and his job” embody these kinds of judgments.
The “reality” in reality therapy refers, of course, to the idea that clients
who are not fulfilling the cultural norms—having social skills, working
hard, taking healthy risks, delaying gratification and so on—are unlikely to
accomplish their dreams and ambitions. Reality therapy gives its practitioners
a good map to assess and guide their interventions. Using this map, they not
only can point out when clients are making bad choices—“how’s that work-
ing out for you?”—but they are also not shy about intervening and using
whatever pressure is available to them to help the client understand that there
is actually only one way to go: fulfill your needs via adapting to cultural
norms. In this sense, for example, a reality therapist is probably more likely
than a standard therapist to recommend “tough love” for a teen or encourage
a spouse to confront a husband who is underemployed.
Assuming Apollonian power is not only occasionally required in the midst
of therapy; sometimes it is a necessary precursor to beginning therapy. It is
a form of “bringing the client to the table.” Often, therapists encounter situ-
ations where a family member could benefit from therapy but is too fright-
ened to come in for a meeting. Sometimes they hide this fear by disparaging
therapy, but it takes little insight to realize that they dread exposure to their
feelings, believe they lack power in their relationships, or fear they will be
proven inadequate when it comes to mastering the next developmental stage
in their life. This resistance is, of course, a form of hyperstability. Common
examples include a husband who is afraid to come into therapy because he
will have to deal with his wife’s dissatisfactions and the teen that is afraid to
take the next step in a maturation or healing process.
 Apollonian Power 201

Often clients with this level of fear and hyperstability will only enter
therapy through an Apollonian intervention—they need to be forced or pres-
sured out of their constricted position. Sometimes a family cannot move
forward without one spouse stating, “unless you do X, I will withdraw my
affection from you. And I may escalate this threat to include withdrawal from
the relationship.”
Therapy with teenagers frequently needs to blend Apollonian interventions
with the Dionysian. Some teens will not even begin to process their feelings
until they experience an Apollonian boundary that forces them out of their
hyperstable position. The case of the anorexic teen that was featured in the
previous chapter had an Apollonian preamble which illustrates exactly this
point.

Prior to meeting the teen, my original session was with the parents. As men-
tioned above, they detailed a history where the teen was essentially running the
household via a combination of temper tantrums, suicide threats, and physical
attacks on her mother. She would then promise she would behave better if her
parents would accede to some wish such as letting her go to a certain summer
camp, taking her on a surfing or snowboarding trip, or allowing her to attend
private school.
The mother was in favor of requiring the teen to eat as prescribed by the
nutritionist; the father doubted that such a direct approach would work. The
mother was physically afraid of the teen and wanted to use more discipline or
send her to a treatment program; the father kept pointing out that the mother,
with her more direct confrontations, fanned the flames of the teen’s anger, and
refused to support more discipline until the “mother issues” were resolved. Both
parents hoped that she would get better every time they said “yes” to another
request.
Finally, the situation was complicated by the fact that the teen was enrolled
in a highly desirable boarding school and both parents were loath to do anything
that might interfere with her functioning at school. It should be added that her
behavior at this school was polite, respectful, and well controlled; in fact, the
only sign that she was different than her peers was that she tended to avoid most
carbs and high fat foods in the cafeteria.
Given this situation the teen saw little likelihood that attending therapy or
cooperating with her parents and the rest of the treatment team would improve
her position. She was already in the private school she desired and fundamen-
tally dominated family decision making via her combination of threats and
promises. It seemed unlikely that she would be invested in change as long as
the status quo was maintained.
Moreover, anyone who has experience with teens understands that they often
see therapy the way Berger and Luckmann frame it: as a way to compel them
to behave according to cultural norms. The teen had been seeing another thera-
pist for months—and the reports of her interventions from the parents made
202 Chapter 9

her sound competent and caring—but she had been unable to build meaningful
rapport with the teen, much less succeed in helping her reexamine her poor
choices. Not wishing to suffer her fate, I decided that the teen needed to be less
comfortable with the status quo in order to increase her motivation to participate
in therapy.
I met with the parents three or four times with the explicit purpose of motivat-
ing them to change the household rules. There were two cards they could play.
First, her misbehaviors had reached a level where the police could be called
and, if she did not moderate her behaviors, she would become involved with the
juvenile justice system in terms of probation and other consequences. Second,
and more important, the teen desperately wanted to continue to attend her board-
ing school. In fact, she had the same feeling about the boarding school that she
had about her eating: if she could succeed at this high status boarding school
somehow all would be right with her life. In short, attendance at this school, like
eating a “pure” diet, had become linked with her ultimate concern.
These facts made it easy to counsel the parents. I simply told them they
needed to require their daughter to eat exactly as the nutritionist had prescribed
and that she would be consequented if she did not. Moreover, if she continued
to act out violently or with threats of suicide, the police or mental health team
should immediately be called. I also asked the parents to tell the teen that if she
did go on probation—or get hospitalized for a suicide threat—that it was highly
likely that her private school would ask her to leave.
Given that her commitment to attending the school was unconditional, and
given that she had already shown an ability to control her emotions and behav-
iors while in the boarding school, I was confident that the teen would choose
to comply with her parents’ reasonable requirements. Of course, it took several
sessions of meeting with the parents to set up the plan given that they were
polarized into the father being permissive and enabling and the mother punitive
and authoritarian. Moreover, both parents were nervous that the girl would make
bad choices and lose her chance to finish the year at the school, an outcome that
both parents dreaded. Be that as it may, the parents were both capable people
with sincere love for their child, and they found the current situation unbear-
able; in sum, after 3 sessions discussing a plan to enforce compliance and all
the things that might go wrong, they committed to using the new approach over
Christmas Break.
They did have some conflict with their daughter—the police had to be called
once—but by the time of my first session with the teen the first week in Janu-
ary, she was eating more normally and essentially behaving according to family
rules. The parents reported that the teen’s mood was more stable than it had been
in months and that there was a general feeling of relief in the family.

Like many Apollonian interventions, this one was easy to design but challeng-
ing in terms of the implicit conflict. I was confident that it would succeed given
the factors enumerated above but the parents were terrified that the teen would
choose the self-destructive option and refuse to comply. Just as Dionysian
 Apollonian Power 203

interventions often require creativity and high levels of compassion, Apol-

lonian interventions require clarity and courage. Sometimes, as in this case,
the intervention must be executed by the parents or a spouse. They have to do
the hard and emotionally dangerous work. Their fear and dread of such work
is palpable. They need to lean on the clarity and courage of the therapist to set
the boundaries, require compliance, and administer consequences.
Clarity and power, of course, are often the difference between a successful ther-
apeutic intervention and just another session of talking on and on and on. It is the
therapist’s responsibility to discern how powerful an intervention the client can
handle, but reality therapy enjoins us to believe that clients can step up to more
than we think they can. Many people remember Jack Nicholson’s famous line
in the movie A Few Good Men: “The TRUTH! You can’t handle the TRUTH”
(Reiner, Brown & Scheinman [Producers] & Reiner [Director], 1992). Glasser
and the Apollonians are confident that clients can not only handle the truth, they
can flourish when they are exposed to it. Their confidence that their clients can
“rise to it” upwardly redefines the limits of human change and adaptability.
In this situation it was not only ethical to use pressure with a client, but
avoiding the use of this kind of pressure was probably unethical. The teen
was firmly fixed in her negative stance and was unlikely to change without
the parents changing the family rules. In addition, it was improbable that she
would bond with me regardless of any brilliance I might have manifested in
individual therapy. I felt certain that no significant progress could occur until
the parents had forced the teen out of her hyperstable position.
In truth, most therapists make stronger—more Apollonian—interventions
whenever they trust their “map.” Paradoxically, the ability to discern between
fundamental and constructed reality often enhances the therapist’s trust in
her own judgment. One might think that Reality B therapists would be more
confused about when and how to use therapeutic power given that they know
“it’s all made up.” Instead, this discernment leads to an understanding of
just how important it is to succeed at Apollonian challenges without any real
attachment to certain aspects of the Apollonian.
In the case of the teen above, I acted more Apollonian than the previous
therapist. The girl excelled at the Apollonian value of achievement but was
woefully lacking in the areas of responsibility and respect. This imbalance
quickly jumps out of the story. The previous therapist was limited by her
overvaluing of the concept of client self-determination; in a sense, that had
become her “ultimate concern.” Conversely, for the Reality B therapist, all
Apollonian values are seen as necessary and helpful along the road of per-
sonal evolution but none are seen as ultimate. This creates a kind of “light
touch”; good judgment and courage are facilitated because of a lack of attach-
ment. In other words, I was better able to be Apollonian because my Reality
B stance allowed me to support the principle without becoming lost in it.
204 Chapter 9

But Glasser did not write Reality Therapy to tone down excessive Apol-
lonians; rather, he believed that too many therapists had given up their power
and effectiveness because of an excessive attachment to being client centered.
It is interesting—and somewhat surprising—to find him joined in this opinion
by two of the most Dionysian therapists in this book, Frank Farrelly and Carl
Whitaker. Farrelly, who is of course famous for his humorous and unconven-
tional interventions, has this to say about pressuring clients.

To sum up, then, frequently in clinical practice as in life, a distinction must be

made between short term “cruelty” with long term kindness on the one hand
versus short term “kindness” and long term detriment on the other. There is
a strongly prevalent myth in the field of child rearing (where the half-life of
“truth” has been estimated at 10 years) that punishment or negative reinforce-
ment or irritation toward another whose behavior the helper is supposed to be
shaping will have an infallibly negative effect. Yet the socialization of children
in any culture is invariably implemented with love, tenderness, and massive
counter-force, violence, punishment, withholding of food, forced social isola-
tion, and similar “dog obedience training” methods. In our opinion punishments
will always be used; the question is whether they will be effective and explicit
or ineffective and apologetic. In all probability there will always be sadists in
many walks of life including the mental health professions, but a distinction has
to be made between sadism and taking pleasure in venting long overdue, justifi-
able anger towards the client or patient and enjoying the consequent changed,
prosocial behavior in the “subject.” If love is not enough, neither is punishment;
the two together can be remarkably effective in changing behavior. (Farrelly &
Brandsma, 1981, p. 51)

And in that same spirit, let’s examine a quote from Carl Whitaker—another
famous therapist with a marked Dionysian style.

The secret of being a good parent is in the enjoyment of being hated at times,
rather than fearing it. (Neill & Kniskern, 1989, p. 367)

Clearly both of these “therapeutic wizards” are suggesting that many thera-
pists have a blind spot when it comes to using “dog obedience training”
with clients. And both are arguing that therapy is more effective when such
tools are included in the therapeutic armamentarium. Finally, both are urging
therapists to move through their fear of conflict and judgment when it will
benefit the client. Both Whitaker and Farrelly embody the principle that the
most effective wielder of Apollonian power is the least Apollonian therapist.
In sum, Apollonian interventions are required in numerous situations with
clients. Many therapists have hesitations about using these interventions.
Some of the key reasons for hesitation include compassion for clients who
 Apollonian Power 205

have been injured by expectations, ethical stances against pressuring clients,

fear of conflict, and a humble resistance to donning the mantle of Apollonian
power. Working through such hesitations is facilitated by having a “clear
map” such as the one offered by reality therapy, or—in a much more nuanced
and holistic way—by the Tillichian hierarchy. Finally, even when hesitations
are removed by study and experience, the therapist will need to manifest
courage and, just as importantly, step up to her symbolic role as the emissary
from the dominant culture.

THE BASIC MODEL

If a temple is to be erected, a temple must be destroyed.

—Friedrich Nietzsche, On the Genealogy of Morality (1887)

The clarity and simplicity of the reality therapy model offers a number of
insights into the provocative and baffling outcome research results. Counter
intuitive as it might be, we know that beginners are as effective as experts.
This equivalence in results suggests that beginners need no training; they
arrive at the starting gate of their therapeutic career already prepared to be
effective. Second, their preexisting knowledge of an effective change model
implies that the model must be simple and reflective of common sense. For
beginners to match experts they must already have an internalized map of
change—something that is readily available to any cultural member.
Reality therapy is certainly simple; it can be explained in a sentence and
understood in five minutes. A responsible and caring therapist helps a client
understand his current status in the culture—his current position in the Net—
and tells him that he can more effectively meet his personal needs by a certain
plan that will advance his cultural position. The reason that it takes even five
minutes to explain the reality therapy model is that the teacher needs to take
a moment to show why preexisting ideas about diagnosis, mental health, and
trauma must be discarded. And that’s it.
More important, however, is the concept that the new therapist arrives
with the model already internalized—that they are already aware of factors
such as the client’s position in the culture and what is required to fulfill the
client’s needs more effectively. Edward Wilson, the evolutionary biologist
whose work was briefly reviewed during the discussion of faith and doubt,
has reflected on this issue of human social competence for years. He believes
that humans specifically evolved to achieve advanced social skills, the very
skills required by therapists. Moreover, as he points out in the quotes below,
many, many humans are so fixated on mastering these skills that they rehearse
206 Chapter 9

and practice them incessantly. Wilson begins his thesis by discussing the
rapid evolution of the human brain required to achieve this level of social
competency.

Prior to the habilines the prehumans had been animals. Largely vegetarian, they
had humanlike bodies, but their cranial capacity remained chimpanzee-sized
at or below 600 cubic centimeters (cc). Starting with the habiline period the
capacity grew precipitously to 680cc in Homo habilis, 900cc in Homo erectus,
and about 1400cc in Homo sapiens. The expansion of the human brain was one
of the most rapid episodes of complex tissue evolution in the history of life.
(Wilson, 2015a, pp. 23–24)

Next Wilson discusses what these new humans did with their enhanced brain
capacity.

Today, at the terminus of this evolutionary process, our immense memory

banks are smoothly activated to join past, present, and future. They allow us to
evaluate the prospects and consequences of alliances, bonding, sexual contact,
rivalries, domination, deception, loyalty, and betrayal. We instinctively delight
in the telling of countless stories about others, cast as players upon our own
inner stage.
. . . People are intensely interested in the minutiae of behavior of those around
them. Gossip is a prevailing subject of conversation, everywhere from hunter-
gatherer campsites to royal courts. The mind is a kaleidoscopically shifting
map of others inside the group and a few outside, each of whom is evaluated
emotionally in shades of trust, love, hatred, suspicion, admiration, envy, and
sociability. (2015a, pp. 22–24)

Wilson is arguing that we have an enormous capacity to measure, predict,

and respond to our social world. To give just one example of the level of
social skills and sensitivity of an acculturated human, examine the follow-
ing experiment that Malcom Gladwell shares in his book Blink. The experi-
menters were attempting to determine whether an analysis of doctor patient
conversations could predict which surgeons would be sued for malpractice.
Not surprisingly, the researchers found that the doctors who had never been
sued spent more time with their patients, laughed more, and made more active
listening comments. But Gladwell (2007) was most interested in how the next
researcher extended these findings.

The psychologist Nalini Ambady listened to Levinson’s tapes, zeroing in on the

conversations that had been recorded between surgeons and their patients. For
each surgeon, she picked two patient conversations. Then, from each conversa-
tion, she selected two ten-second clips of the doctor talking, so her slice was
 Apollonian Power 207

a total of forty seconds. Finally, she “content-filtered” the slices which means
she removed the high-frequency sounds from speech that enable us to recognize
individual words. What’s left after content-filtering is a kind of garble that pre-
serves intonation, pitch, and rhythm but erases content. Using that slice—and
that alone Ambady did a Gottman-style analysis. She had judges rate the slices
of garble for such qualities as warmth, hostility, dominance, and anxiousness,
and she found that by using only those ratings, she could predict which surgeons
got sued and which ones didn’t. (p. 42)

Socialized humans are so adept at interpreting subtle social clues that they do
not even require content to discern the essence of a social interaction. And
they can make that determination after listening for only forty seconds.
Individuals who choose to be therapists are likely to be even more skilled
at these social cues than the average member of the culture. So when it comes
to reality therapy, therapists and coaches are going to be expert at discerning
and understanding the “dysfunctional nature of her current choices.” They are
already experts at establishing rapport and already understand how the culture
operates and what kind of plan might fulfill client needs more effectively. In
sum, the new therapist arrives at the beginning of her professional career with
a high level of pre-established proficiency. She is an expert before she walks
in the door and, as someone who is already fully developed, more training
in the areas of her expertise is unlikely to significantly enhance her social
competency.
This preexisting clinical expertise of the new therapist—and even lay
people—is often witnessed by the experienced therapist. Who has not done
family therapy or group therapy and had untrained individuals generate case
conceptualizations every bit as deep and meaningful as anything developed
by an experienced therapist? And it is even more common for a group of
beginning therapists to produce theories and interventions identical to and
sometimes superior to the ones created by their supervisors and teachers. The
new therapists may not be as skilled at couching the interventions in the lan-
guage endorsed by a certain psychotherapeutic system, but they are usually
terrific at grasping the main ideas and the central issues.
To review, the first reason that beginners achieve results equivalent to
experts is that they never were beginners in terms of advanced social and
cultural competence; they are only beginners in terms of learning the details
of therapeutic systems (whose contributions do not enhance therapeutic effec-
tiveness). Moreover, as experts, their effectiveness in this area is unlikely to
increase with more experience.
And, in addition to shedding insight on why beginners get results equiva-
lent to experts, reality therapy provides a gut-level understanding of why the
various psychological systems provide no added value in terms of outcome.
208 Chapter 9

When reality therapy can be learned in five minutes, and when its outcomes
are as good as much more complex systems such as psychodynamic psycho-
therapy, one can have an inner sense about the futility of developing intricate
psychological systems. In truth it feels “wrong” that reality therapy is as
effective as Family Systems therapy or Jungian therapy—both of which are
characterized by deep and moving texts that are highly nuanced and which
require careful review to fully understand—but there it is. More complex,
deeper, more impressive and more thoughtful does not translate into more
effective.1
Occam’s Razor argues that when there are two competing theories describ-
ing the same phenomena, it is best to pick the simplest unless there are com-
pelling reasons to choose the more complex. The implications of this are so
important and so provocative that it is worth repeating the basic argument.
The equivalence of reality therapy to more complex schools of therapy sug-
gests that all therapy boils down to a wise and caring person telling a client
that they ought to behave in ways that meet their needs more effectively.
Everything else consists of bells and whistles; when it comes to outcomes,
everything else is extraneous fluff. And, worst of all, pretty much any socially
competent member of the culture can pull this off.
Why is this empowering? Because when the basic model is defined, it
highlights what must be superseded in order to achieve above-average perfor-
mance. In the case of therapy, no techniques have ever been developed that
are superior to simply telling a client that they ought to do something better.
But the way that this message is delivered—in other words, the charisma
attached to the message—results in a significantly different impact on the
client.
Finally, we need to discuss how embracing an Apollonian stance can be
helpful in terms of enhancing therapist charisma. Recall the question from
chapter 6: “What if the focus shifts to how the experiences in the room facili-
tate or diminish therapist charisma?”
For the development of charisma, the emphasis must be on mastering the
essence of the Apollonian approaches. The essence of Apollonian therapies is
the domination of the conscious over the unconscious. The essence of being
an Apollonian therapist is the ability to embrace one’s role as a designated
representative of the culture with the corresponding ability to be directive,
success-oriented, and have an appropriate sense of right and wrong.
Of course all these factors are constructed, relative, and culturally variable;
however, from the standpoint of developmental needs—Tillich argues that
individuals need to master the Apollonian before proceeding to the Diony-
sian—there is integrity in playing such a role. Put another way, mastery of
the basic goals of life are so central to human functioning that the attempt to
cultivate therapeutic charisma without a grounding in the Apollonian is futile.
 Apollonian Power 209

It was no accident that Farrelly and Whitaker, two overtly Dionysian thera-
pists, were so adamant about the importance of boundaries and the ability to
support/impose them.
An enhancement in charisma occurs when the therapist internally owns the
essence of an approach. When we read Glasser’s story about confronting the
boy with his own behavior—and feel the power and certainty running through
the story—we have an opportunity to develop our Apollonian power; when
we manifest that same energy in our own practice, we enhance our charisma.
At the end of the day, we are not trying to learn reality therapy, we are trying
to experience in our own process what Glasser felt the moment he blurted
out to the boy:

I told him to shut up and for once in his life to listen to what someone had to
say. I informed him that the play was over, that we would sit and talk in an
adult fashion, or if we walked we would walk as adults. I explained clearly that
I would not tolerate any running away or even any impolite behavior while we
were walking. He would have to be courteous and try to converse with me when
I talked to him. (1965, p. 138)

NOTE

1. Lest Realty therapy be portrayed as a superior psychological system, it should

be clear that it has significant issues. For example, while reality therapy offers the
benefits of a clear map and empowers its therapists to make powerful interventions, it
is built on shaky foundations. The first problem, obviously, is that Glasser never ques-
tions his use of the word “responsible” and his assumption that operating inside the
culture will lead to needs fulfillment. In many ways, of course, Glasser’s assumptions
in this area are appropriate. In most of the case studies presented in this book, simply
helping a client to master the next developmental stage as defined by the extant cul-
ture would suffice as a moral “place to stand.”
Constructionists, of course, respond that such simple ideas of responsible
behavior eventually betray the less enfranchised members of that culture. Feminist
therapists argue that these kinds of traditional ideas violate a woman’s sense of self,
her freedoms, and her right to choose. Similarly, advocates for virtually all cultural
minorities point out that clichéd ideas of right and wrong, especially when advanced
by high status members of a culture, often lead to inequity, injustice, and mistreatment
for the lower status person. Chapter 3 went over detailed examples of how easily an
imperialistic psychology can oppress minorities and representatives of non-dominant
subcultures. For these reasons, constructionists argue for disassembling all the
assumptions in a culture. A therapist who has taken the cultural assumptions apart has
a better chance of avoiding an imperialistic stance.
 Chapter 10

Identity

Do I contradict myself? Very well, then I contradict myself, I am

large, I contain multitudes.
—Walt Whitman, “Song of Myself” (1854)

Confusion about the nature of the Self is one of the defining aspects of the
Abyss. Not surprisingly, therefore, it also becomes one of the central focuses
of the Net. Working effectively with the concept of the Self is one of the
hallmarks of a Reality B therapist. And one gets far more interesting answers
if the first question is not, “What is the nature of the Self?” but rather, “How
many selves exist?”
This question of “how many selves?” is less a function of truth and more
a function of pragmatism and usefulness. Common experience supports
the existence of one self and the existence of multiple selves. Everyone, of
course, has the sense that “I” exist. The “me” that went to sleep seems identi-
cal to the “me” that wakes up. The “me” from childhood is united with the
“me” of adulthood.
Conversely it is just as common to recognize the multiple selves within.
The statement, “A part of me wants to marry him and a part of me doesn’t”
is so common as to be unremarkable. “I have to talk myself into going to
the party” of course implies multiple selves. And “my angry part takes over
and makes me do things I regret” has the same implications. G. I. Gurdjieff
comments:

Man has no individual i. But there are, instead, hundreds and thousands of
separate small “i”s, very often entirely unknown to one another, never coming
into contact, or, on the contrary, hostile to each other, mutually exclusive and
incompatible. Each minute, each moment, man is saying or thinking, “i.” And

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each time his i is different. Just now it was a thought, now it is a desire, now a
sensation, now another thought, and so on, endlessly. Man is a plurality. Man’s
name is legion. (Ouspensky, 2001, p. 59)

Apollonians love the concept of the unitary self. Since one of their primary
values is responsibility, and multiple selves by definition allow a person to
escape personal responsibility, the Apollonian has a strong tendency to affirm
the unitary self. Moreover, the unitary self implies stability, continuity, and
permanence—other key Apollonian values.
Dionysians, conversely, are enchanted by multiple selves. This view gives
them more freedom to respond with fluidity, creativity, and spontaneity. The
Whitman epigraph above is classically Dionysian and emphasizes acceptance
of contradiction, complexity, nuances, and shades of gray. Conversely, the
Apollonian concept of responsibility is relatively black and white, clear, dis-
cerning, and judging.
The contrast between these two models became very clear to me early in
graduate school. I had chosen to attend the University of Montana for my
doctoral studies in clinical psychology for a variety of reasons, but one of the
main ones was the presence of Dr. Jack Watkins on the faculty. Dr. Watkins
has had a long career and made a variety of significant contributions to psy-
chology, but he is most renowned for his development of clinical hypnosis
and ego state therapy. Subsequent to World War II, Dr. Watkins, along with
other luminaries such as Erickson in Arizona and Hilgaard at Stanford, was
instrumental in introducing hypnosis into clinical psychology and helping it
become accepted as a valid therapeutic technique. As part of his work with
altered states, hypnotic amnesia, and related concepts, Dr. Watkins undertook
studies of multiple personality disorder (MPD) and became an expert in that
area. Not surprisingly, his expertise with hypnosis and MPD interested the
justice system and he often functioned as a forensic psychologist and expert
witness.
One of his most famous trials involved Kenneth Bianchi, the Hillside
Strangler. Bianchi was denying any memory of the murders and Dr. Watkins
was asked to examine him. He met with Bianchi, put him into a trance, and
determined that Bianchi was a multiple. This news was not greeted positively
by the prosecution who of course believed that Bianchi was dissembling
about the MPD in order to receive a reduced sentence for his crimes. The
prosecution essentially argued that, at worst, Dr. Watkins had been taken in
by a con man; and, at best, Dr. Watkins had “created” the MPD as a result
of the hypnotic trance. Dr. Watkins supported his position via submitting
tapes of his hypnotic sessions and providing other supportive material such
as a sculptured bust made by Bianchi with a normal face on one side and a
hideous face on the other. Given the heinous nature of his crimes, it was not
 Identity 213

surprising that judge and jury resolved the issue by ruling in favor of the
prosecution.
This case is a perfect representation of the struggle between the Apollonian
and the Dionysian in terms of defining reality. Virtually every therapist is
familiar with this struggle. For example, I have a fair number of college stu-
dents in my practice and almost every semester I receive a request or two for
a letter stating that the reason that the student failed her course was because
of depression, or panic disorder, or overwhelming stress. The professor, of
course, has the default Apollonian position that the student should master
herself sufficiently to complete the course work; my letters, conversely,
essentially state that the well-intentioned student part was overwhelmed by a
mental health-related part.
Who is right: Watkins or the prosecution, the professor or the psycholo-
gist? Constructionists respond that neither the Apollonian perspective nor the
Dionysian are superior; the “truth” is utilitarian and relative. The professor
can defer and change the “F” to an incomplete without harming much of
anything. The culture pays a much bigger price when it condones murder—
especially serial murders—secondary to a mental health condition. Multiple
selves removes responsibility; unitary self emphasizes it. When it comes to
justice, Apollonian is usually superior. When it comes to change, multiple
selves and the Dionysian perspectives are generally more effective.
The interaction between psychology and the justice system has been
used to illustrate one aspect of the struggle between the unitary-self and the
multiple-self models. The “truth” is that there is neither a unitary self nor
a fixed number of multiple selves. Personal identity is an area where the
constructed nature of reality is seen most clearly. Without thinking of the
philosophic implications, people in general, and therapists in specific, create
and destroy parts, selves and identities every day. The same student who asks
me for a letter in the morning, explaining how his responsible “student self”
got overwhelmed by his “anxious self,” presents himself at a job interview in
the afternoon promising to be responsible and reliable. Later in the day, he
tells his girlfriend that he intends to be faithful to her while simultaneously
knowing that his “player” self will be out that same evening when he goes
drinking and dancing with his friends. Martin Buber said, “The origin of all
conflict between me and my fellow-men is that I do not say what I mean and
I don’t do what I say” (as cited in Wooster, 2016, p. 117). This quote implies
self-knowledge—who is making the promise and who is keeping it—and
self-mastery—“I choose to honor what was promised by my one self although
I may no longer be that self.”
The “unitary self versus multiple self” dilemma is not only one of the
primary characteristics of the Abyss, it operates throughout daily life. Indi-
viduals alter their identities frequently and casually and are so comfortable
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with the process that they take little note of it unless it gets them in serious
trouble (e.g., with illegal activities or breaking a promise to a lover). Certain
misbehaviors generate wrathful Apollonian judgment but most variability in
the self is considered “normal” and excused and overlooked. Finally, since
shifting the Self implicitly participates in the full power of the Abyss—both
for constructive and destructive purposes—it is included in some form in
almost all therapeutic systems.

EGO STATE THERAPY: DIONYSIAN DISSOCIATION

I am a forest, and a night of dark trees: but he who is not afraid of my

darkness, will find banks full of roses under my cypresses.
—Friedrich Nietzsche, Thus Spake Zarathustra (1896)

Many psychologists believe that attachment theory—with its compelling

explanations of the mother-child bond and its subsequent predictions of
healthy human functioning—is the central theory of human development.
To constructionists—who are most focused on how an individual is social-
ized into a culturally constructed reality—the most important developmental
process is how one learns to see reality from a certain shared and socially
validated perspective. While there are many benefits to being initiated into
a social reality, there are also drawbacks. One of the chief drawbacks is that
every member of the culture is forced to struggle with guilt and shame. The
old saying “no one gets through childhood unscathed” applies here. Virtu-
ally everyone has experiences where they internalize feelings that imply that
they are bad, inadequate, or deviant because they fail to master a certain
cultural value or perspective. Ram Dass, the clinical psychologist and spiri-
tual teacher, finds this relationship with guilt and shame so central that he
summarizes it with, “Your problem is you are too busy holding on to your
unworthiness” (as cited in Ducey, 2015, Self Love).
Shame and guilt require a unitary self; I am responsible for my mistakes
and my resulting shame and guilt. Conversely, releasing shame and guilt
either requires some sort of penance and making amends—working our way
out of shame and guilt through good deeds and right action—or releasing the
dark feelings by attributing poor judgment and bad behavior to another part
of myself. “I” know better but this confused or traumatized or miseducated
part of me did the bad deeds.
This concept is so powerful that it essentially becomes part of almost every
psychotherapeutic system. When paralyzed by guilt and shame, adopting
a multiple-self perspective is not only Dionysian, it is like stepping on the
accelerator in a car: change happens relatively easily when the client is no
 Identity 215

longer frozen with remorse. Conversely, adopting a unitary-self perspective is

like stepping on the brakes; everything is stabilized and locked into place. To
illustrate how this operates in a therapy office, let us examine how one school
of therapy, developed by the same John Watkins discussed above, works with
shame and guilt.
In addition to his forensic interests, Watkins continued to develop his inter-
ests in MPD via creating a new way to do therapy that he called Ego State
Therapy (EST) (cf. Watkins, 1993). EST is an approach which allows a client
to touch his traumas, failures, and poor choices without being overwhelmed
by a personal sense of responsibility or identification with those negative
memories. In EST, a client is invited to imagine that he has an inner family
of “ego states” which, although separate parts, collectively form his complete
identity. The client is then asked to understand the perspective of each part,
mediate between conflicted parts, and suggest that certain parts change or
make compromises. Sometimes this work is done in trance and other times it
is done as a form of “chair work” with each part being placed in a seat and
the client moving between seats.
The parts are described and experienced as autonomous both from each
other and from the main personality. Therefore, if these autonomous parts
have been responsible for bad choices or reprehensible behaviors, the primary
self can feel relatively free of guilt and shame. Typically, the main personal-
ity is urged to move toward the misbehaving parts with love, understanding,
and acceptance. It is a form of “embracing the shadow.” And, as a result of
the reduction of guilt, the increase of the sense of agency and personal power,
and the presence of love and forgiveness toward the “dark” ego states, the
average client paradoxically reports feeling more integrated, more empow-
ered, and possessed of great insight. Following is a case example of EST from
my own practice.

A 26-year-old, Caucasian male presented in therapy with complaints of anxiety,

anger outbursts, and general confusion and agitation. The client had reported
that he had been popular in high school and had been a gifted football player.
Since high school he had essentially drifted through life, drinking on a daily
basis, partying hard on the weekends, and only able to work part-time. He had
primarily been raised by his divorced mother, with the help of her parents, and
had been rejected by his biological father who was an officer in the military.
His mother was very moody and would alternate between being supportive,
abandoning, and, on occasion, abusive (e.g., she once threw hot tea on him when
he was sleeping).
The therapy began with a referral to Alcoholics Anonymous. The client
felt at home there and was quickly able to commit to and achieve sobriety.
Approximately six months later, he decided to address his under employment
issues by trying to become a firefighter. This choice required him to enroll in
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the local community college for some basic courses and for the fire academy.
Unfortunately, when he stepped on campus to register, he experienced a severe
panic attack and had to come home immediately. He felt discouraged and was
certain that any attempt to return to the campus would rekindle his panic feel-
ings. He exhibited marked shame and guilt, reported that he had always known
that he was a “loser,” and stated that he would never amount to anything in life.
At his next session, the client was introduced to the concept of ego state
therapy and a list of important parts was co-created between the two of us. A
label describing each part was put on each of 6 seating locations in the room and
the client was instructed that when he occupied each seating position, he could
only think, feel, and speak as that part of his personality. A dialogue was con-
ducted between the therapist and the various parts which helped him understand
the nature of each part and allowed him to practice quickly switching from part
to part. This, of course, not only provided insight but fostered dis-identification
from each part.
He had named one part “Marie,” which was his mother’s name, because he
felt that this part was weak, confused, dependent and fearful just like his moth-
er’s personality. He noted that he hated this part of his mother and felt ashamed
that he had internalized an equivalent part. Not surprisingly, he also had a part
he named, “Colonel Critical,” which he believed symbolized his father. This
Colonel part was actively critical of the Marie part and repeatedly heaped shame
and abuse upon her.
The next session he accessed a part, which he called the “big brother,” which
embodied all the ways that he had helped and supported children and other
people in his life. This part was able to move toward the Marie part and explain
to her that her fear and sense of worthlessness was natural given what she had
experienced in life. The big brother part also pledged to protect the Marie part
from the Colonel.
In the weeks following the sessions the client was able to return to campus.
While he felt some initial anxiety, the anxiety quickly faded and he was able to
register for classes. He went on to complete the fire academy and got a desirable
internship with a local fire department.

This is a fairly classic example of EST. As has been demonstrated, once the
parts model is adopted, it is relatively simple and straightforward to resolve
problems and conflicts. Simply work with the individual using basic family
therapy techniques.
EST and most dissociative techniques are a kind of constructionism-in-
action. For example, suppose a client presents with social anxiety. It is simple
to gesture toward a chair and state, “when you sit here, I want you to be the
part that protects you from being hurt at a party. When you sit in that chair, be
the little boy that was scared, and when you sit in the final chair, be the wise
part that knows what to do to integrate these parts and to solve your anxiety
issues.” Did the parts exist before? In truth, the client had never considered
 Identity 217

his behavior from that perspective. But they exist now and the client is likely
to congruently play out each part with insight and appropriate affect simply
because I asked him to do it.
Experiences like this help the therapist “feel” the malleability of reality. A
client who had no insight about the origin of their social anxiety is discussing
it articulately and with feeling within five minutes of sitting in the chair. Was
there really a childhood origin to the anxiety? Perhaps it only existed because
I suggested he sit in the “little boy” chair. But if the client tells a healing story
about the interaction between these three parts—and then can start attending
social events—who really has the right to complain that the healing is unsub-
stantiated because it was implicitly suggested by the therapist?
In this sense, accepting multiple selves leads directly and indirectly to
constructionism. Once the new self is created—by therapist, by client, or
serendipity—it becomes as “real” as the preexisting self or selves. Yet it was
created “ex nihilo” and is composed simply of intention. Moreover, there are
no limits about how many selves can be created or for what purposes.
Multiple selves versus the unitary self is one of the defining characteristics
of being Dionysian, being a constructionist, and, paradoxically, of being inte-
grated. Multiple selves are not only helpful in terms of reducing or removing
guilt and shame, they not only facilitate change and growth, they also are
necessary to encompass the complexity of human experience. As Whitman
argues in the quote at the beginning of this chapter, to be fully human is to
embrace multitudes. Awareness of the fluidity of self and the capacity to
use this consciously and thoughtfully is transformative both for client and
therapist.

APOLLONIAN APPROACHES TO DISSOCIATION

Consistency is the last refuge of the unimaginative.

—Oscar Wilde, “The Relation of Dress to Art,”
The Pall Mall Gazette, February 28, 1885

Returning to the Berger and Luckmann argument that all cultures are required
to socialize their children into the prevailing cultural reality, it is not much of
a stretch to understand why shame and guilt are so widespread and so para-
lyzing. Apollonian enculturation requires use of rewards and punishments.
It is difficult for some members to become high functioning and successful.
And with each failure and disappointment, the acculturating individual feels
increasing shame and guilt for her inadequacies. Of course, the hope is that
this shame will be motivating and result in an increased effort to master
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socialized behaviors. Unfortunately, for a certain percentage of individuals,

the increased shame simply results in hopelessness and passivity. Instead of
increased motivation and a good outcome, there is a collapse into helplessness
and self-deprecation. Often this guilt and shame is accompanied by anger that
the individual is being forced to play a game that they can never win.
Therapists, of course, see a good many clients who have never socialized
successfully and who are imprisoned by this sort of helpless, hopeless, self-
deprecating experience of life. While it is possible to use direct techniques
with such clients, even the most Apollonian therapist will be drawn into the
use of dissociative techniques to deal with this level of self-hatred and depre-
cation. James Hillman discusses the importance of dissociation.

[M]ultiplication of personas may be used as a therapeutic tool in order to bring

home the realization that “the ego complex is not the only complex in the
psyche.” By actively imagining the psyche into multiple persons, we prevent
the ego from identifying with each and every figure in a dream and fantasy,
each and every impulse and voice. For the ego is not the whole psyche, only one
member of a commune. Therapy works through the paradox of admitting that
all figures and feelings of the psyche are wholly “mine,” while at the same time
recognizing that these figures and feelings are free of my control and identity,
not “mine” at all. (Hillman, 1997, p. 31)

In this sense, it is not surprising that virtually all schools of psychotherapy

have some technique which embodies dissociation and multiple selves.
For example, when a cognitive therapist tells the client that he adopted
his irrational or unproductive beliefs because he was mistaught or had bad
modeling or had traumatic experiences, he is inviting the client to view his
poor choices and beliefs as inevitable—something any “normal” person
would have done if they had had the same experiences. This normalization
is designed to decrease the shame and guilt implicit in being a mental health
patient whose presenting problem (e.g., anxiety or depression) marks him as
a different and inferior type of person. Then the client is invited to dissociate.
“You are going to keep having these feelings but you shouldn’t worry about
them because they come from another part of you that was confused from
earlier experiences. Stand in the place that is healthy and have compassion for
the part of you that still has these old cognitions and feelings.” Or even more
commonly, “dispute these irrational ideas that come from one part of you by
standing in a healthy place and asserting a more rational interpretation.”
Obviously, it doesn’t take much work to substitute authenticity—from a
humanistic perspective—for irrational beliefs. This process of normaliza-
tion—to minimize guilt and shame—and then dissociation—to reduce over-
whelming negative affect—also occurs with treating trauma and negative or
inadequate childhood experiences. Being part of a rape survivors’ group or a
 Identity 219

post-traumatic stress disorder group ensures that the client will repeatedly and
credibly hear, “Any normal person who went through what you experienced
will feel what you feel. Be kind to each other and to yourself. Suspend judg-
ment and replace it with compassion and understanding. When one part of
you can comfort the hurt part, you’re well on the way to healing.”
Family systems theory has its own particular variation on the dissocia-
tion approach. Often the individual is not even referred to as a self but as
an “identified patient.” As an “identified patient,” the person is not only not
responsible for his misbehaviors, in family systems theory the misbehaviors
of the individual are framed as unconscious attempts to help someone else in
the family system or as actions done for the greater good of the entire family.
Often the individual is asked to “give up” this helpful attitude—the misbe-
havior—and let the family take care of its own issues. In sum, the person did
not perform the misbehaviors; they were performed by a different part that
wanted to be helpful.
Biopsychiatrists also use dissociation and disidentification when they offer
their genetic model and assert something like “you can’t really help being
depressed (angry, anxious, ADD, etc.) because you have three other family
members with the same disorder and research has proven that these disorders
are fundamentally genetic. It’s like diabetes: you have a disease that we can
partially control with medication but never cure. Don’t be so hard on your-
self for all the things you have done as a result of having this condition; your
genetic predisposition left you with no other choice than to feel and act as
you have.”
Perhaps, though, the major school of therapy which uses dissociation most
effectively is the psychodynamic model. Not only did Freud talk about the
urges of the id and the critical lectures of the superego, but the very concept
of the unconscious mind—with its autonomous feelings and associations—
simply begs the individual to dissociate into a “me” and “not me” perspective.
One of the most powerful uses of dissociation, however, comes from AA
and its concept of the inevitability of bad behaviors that arise as a result
of an alcoholic/addict using drugs or alcohol. In AA, the alcoholic/addict
is completely responsible for whether he takes a drink or not, but he is not
responsible for the negative behaviors he emits once he has begun drinking.
This, of course, is because an alcoholic is defined as someone who will inevi-
tably emit bad behaviors if he starts drinking. Given that many alcoholics
have misbehaved fairly profoundly, this definition goes a long way toward
removing the shame and guilt associated with those bad behaviors. And, of
course, alcoholics then target releasing shame and guilt even more thoroughly
via their “making amends” process. One can know the dissociation process
is well accepted when one attends meetings and hears the stories—told with
great pride and even glee—of just how badly the speakers behaved when
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drinking. They can tell these stories without shame because “they” did not
perform the bad acts; it was their “drinking self” who created such havoc.
Using dissociation is not limited to trained therapists. The life coach who
has just hung out her shingle a month ago after taking a weekend workshop
is also likely to use some form of dissociation with her clients. For that mat-
ter, your friend who is discussing your potential marriage is likely to say, “It
sounds like you really love this part of her but can’t stand the other part.” Or
“given how you were raised and what you went through, you shouldn’t be so
hard on yourself.”
Even the most Apollonian systems and therapists are forced to use a disso-
ciative model to deal with guilt, shame, and self-deprecation. The upside, of
course, is that the clients get better. The downside is that with the introduction
of multiple selves, both clients and therapists begin to experience the implicit
ephemerality of reality. They begin to sense the background rumblings of the
Abyss.
Once a therapist or client begins to disassemble reality, nothing is really
stopping her from going all the way. If a therapist instructs her client to let
go of shame and guilt because the misbehaviors were caused by another part
of her psyche, where do these assumptions start and stop? If some of my
behaviors are done by a part of my identity that is “not me,” which of my
behaviors are done by me? The therapist in the middle of the clinical moment
may answer that all one’s positive behaviors are done by the “real me” and all
the negative ones are done by the “false or conditioned or traumatized me,”
but it does not take much thinking to realize that following this argument to
its logical conclusion gets one into incongruences pretty quickly.
The Apollonian response to these intimations of ephemerality is to move
the client back into a unified self and a clear identity as quickly as possible.
Perhaps it was necessary for therapeutic progress to move into a multiple-
self model, but the Apollonian needs to reassert the primacy of the unitary
self. This “reassociation” process is just as important as the progress that was
made via disassociation. The new identity created after therapeutic progress
solidifies the therapeutic gains and has important implications both for sus-
taining those gains and opening the client for further growth.
Often the new identity is formalized via a label. The most obvious examples
of these are identities such as “recovering addict,” “survivor,” and the geneti-
cally vulnerable. Every therapist has had new clients walk into the office for
a first session and explain that they are destined to be anxious because “many
people in my family are anxious.” Or “I have to stay on antidepressants for
the rest of my life because I have a biochemical deficit.” Or “I’m going to
have problems in relationships because my last therapist told me that I have
borderline traits.” Moreover, even when the new identity is not formally
defined in terms of psychopathology, there can still be residual definitions left
 Identity 221

over from encounters with mental health professionals. For example, state-
ments such as “I have a hard time adapting to change,” and “I typically have
intimacy issues in relationships,” may have originally been generated with
good intentions but can have significant negative consequences over time.
Of course, many of these labels carry a measure of relief when they are
first applied. They often act to normalize behavior and the client often feels,
“My symptoms would have happened to anyone who went through my expe-
riences. They are not due to the fact that I am a substandard person.” But it
is possible to limit this kind of normalizing to the early stages of treatment.
It is not necessary to discharge a client with a pathologized label defining his
identity.
The second good reason for such identities is that the client continues to
have symptoms and they need an ongoing, pathologized identity to under-
stand the continued symptoms and to accept them. An obvious example
might be a woman recovering from a rape experience who uses her identity
as a survivor to explain to herself why she has hesitancies, or even full scale
flashbacks, with her new lover.
Such identities can help clients avoid falling back into negative patterns.
Some substance abusers need to be in lifelong recovery because abandoning
the pathological identity of an addict exposes the client to destroying their life
by thinking that they can use drugs and alcohol “like a normie.”
The obvious downside to such labels and identities are that they limit a
person’s capacity to define himself as “normal, strong, or healthy.” This
dilemma is often exacerbated when the therapeutic world tells the client they
are in denial, or ignoring reality, or are riding for a fall when they attempt to
change their identity from pathologized to normal. They are often enjoined to
keep the identity of a recovering person and are informed that they are never
allowed to resume the identity of a recovered or fully functional individual.
There are darker sides to this as well. Gergen argued in chapter 3 that the
proliferation of mental health diagnoses are not secondary to better science
and the careful discovery of how reality is structured. Rather, he saw this
proliferation as an attempt by a profession to maximize its status, power, and
finances. In this sense, “experts” in certain areas are most likely to reassemble
clients’ identities with pathological labels. The ADD expert is more likely
to discharge his patients with a lifelong ADD label and the psychopharma-
cologist is more likely to recommend lifelong medication for an underlying,
genetically based disorder. Such experts are often supported by cultural and
business forces such as ‘Big Pharma’ who work hard to apply pathological
labels to clients and to pathologize normal behaviors such as grief and hor-
monal fluctuations.
Some therapists have personal identities that are somewhat shaky. Such
therapists are Abyss avoidant and frequently use hyperstabilizing strategies in
222 Chapter 10

their own life. The shakier my identity is, less likely I can tolerate ambiguity
in my client’s identity. Moreover, they will have a tendency to impose their
own worldview on my clients in a kind of “If you believe what I believe than
my identity is safer and more stable.” As a result, such therapists are prone
to assigning black and white labels to their clients after dissociation and at
discharge. And the clearest labels are the ones which are pathology centered.
A shaky identity is one thing but an even darker outcome occurs when
the mental health professional has hidden fear of the “abnormal.” It was
previously observed that one of the benefits of diagnosing individuals who
are dysfunctional by conventional cultural values is that the label creates a
boundary between “them” and “us.” In the face of the threat of the Abyss,
separating ourselves from those who are at risk of being devoured by dark-
ness is always tempting.
Achieving superior effectiveness as a therapist always begins with the
therapist having the ability to imagine that the client has the capacity to
change and, preferably, has the capacity to change relatively quickly and
profoundly. As has been demonstrated above, even Apollonians are forced to
use a multiple-self model when clients are seriously blocked and immobile.
However, it is vitally important to understand that Apollonian reassembly of
self is almost always characterized by a labeling process that will slow and
limit healthy change. While it is important to support some pathologized
labels for certain clients—such as those who are self-labeled alcoholics who
wish to maximize their motivation for sobriety—in general such labels should
be viewed suspiciously and probably do more harm than good.

MAKING IT REAL

There are no facts, only interpretations.

—Friedrich Nietzsche, Beyond Good and Evil (1907)

Nothing quite illustrates psychological constructionism as effectively as

the unitary- versus multiple-self dilemma. The more one examines the pos-
sibilities, the more one works with it with clients, the less real and more
constructed it appears. Take an old joke as an example.

Question: How do you drive an Apollonian crazy?

Answer: Put him in a round room and tell him there is a penny in the corner.

This simple joke implies that Apollonians need to see the world as full
of straight lines and corners instead of its true nature: round and curvy.
 Identity 223

Moreover, they seek for false treasure in the arbitrarily constructed corners.
In this case, the penny represents the idolatrous promise of happiness offered
by the illegitimate ultimate concern.
Make the same joke a bit more psychological.

Question: How do you drive an Apollonian crazy?

Answer: Tell him his next client has exactly 6 parts. He needs to discover the parts
and then create an authentic alignment with the healthy part.

Of course the next client cannot have six parts. He has one self or as many
sub-personalities as the client and the therapist co-create. A part does not
shine with its own “authenticity”; rather, the authenticity is derived from the
relationship that exists between the therapist and the client and between the
client and his life.
Approximately twenty-five years ago there was a surge of interest in mul-
tiple personality disorder. Clinics were established and a number of therapists
specialized in treating it. The clinics produced discharge summaries that
detailed the twenty-two multiple selves in the patient, what each part was
like, and made recommendations for how to work with the parts in an ongo-
ing fashion. Not surprisingly, this heyday of MPD was short-lived as many
other therapists made the obvious critique: why should we take your work
seriously when you’ve obviously made it up?
Keep going with the same joke but make it institutional.

Question: How do you drive an Apollonian crazy?

Answer: Tell them they are the Commissioner of Psychology. Their job is to dis-
cover the 174 different mental health diagnostic categories that are truly indepen-
dent and unique. Next they are to develop a specialized manual for each category
that efficiently and effectively treats the extant disorder.

The more a psychologist works with EST or internal family systems, the more
that psychologist is thrust into constructionism and has a personal experi-
ence of “making it all up.” This experience quickly generalizes to related
experiences; hence the evolution of the Apollonian joke from the Apollonian
attempt to make the world full of straight lines, to the Apollonian tendency
to make the next client fit into a preexisting pattern, to the Apollonian wish
to make the diagnostic world fit a simple typology. Take the following case.

A 47-year-old single businessman presented with depression and anxiety

secondary to being rejected by his current girlfriend. The business man was
handsome, wealthy, and had many friends—the epitome of success. He had a
history of difficult relationships with women primarily characterized by lying
224 Chapter 10

and cheating. He had been married for 5 years but cheated on his wife almost
constantly because he didn’t love her and had only married her because she was
pretty and helped him impress his business clients. When he left his wife after
a long term affair was revealed, he tried to have a relationship with his mistress
but left her because he felt that she was “not quite right for me.”
He then started dating another woman but lost interest in her when he learned
that his mistress was dating someone new. He did everything he could to win
back the mistress while simultaneously continuing to date the girlfriend but the
mistress wouldn’t have him back. The girlfriend discovered his campaign to
reaquire the mistress by checking his phone and dumped him.
Upon being dumped, he decided that the girlfriend was actually his true love.
He begged her to take him back and she told him that he needed to do therapy
to discover why he was so compulsive and desperate in relationships.
In the first session, his childhood was reviewed and he explained that his
father was a highly successful CEO who was almost never around. His mother
was passive and loving and his father was judgmental and demanding. When
the father made his brief appearances in the family, he typically criticized his
son citing character flaws and a lack of discipline. The son responded by rebel-
ling with alcohol and minor misbehaviors—a strategy that got him sent off
to military school. He came out of college with a burning desire to achieve,
a sociopathic layer of self-centeredness, and an almost complete lack of self-
knowledge and self-awareness.
The client was told that he had 3 main parts: a wounded child desperate for
attention, a tough achiever/protector, and a healthy part that wanted real inti-
macy. Because he had disowned the child, he needed to reclaim and integrate it.
Similarly the unethical choices of his tough side need to be acknowledged but he
was also asked to cultivate self-compassion because many of the misbehaviors
had been done to protect the sensitive child.
In the next several months, he came for individual therapy and for conjoint
sessions with the girlfriend. The girlfriend, not surprisingly, brought up numer-
ous examples where she had been lied to or misled. The client was required
to fully acknowledge the truth of these accusations and demonstrate, by the
quality of his apologies and subsequent behaviors, that he both owned the bad
choice but simultaneously forgave himself for it. He had to own it because he
had hurt the girlfriend and behaved unethically, but he had to forgive himself
because that “self-forgiveness” would demonstrate that he was finally accepting
his child part. In addition, he had to avoid any further unethical behaviors and
be especially kind to his girlfriend’s mother and child to allow his “sweet side”
(child part) to come out.
While there was a bit of up and down in the relationship over the next few
months, the client fulfilled his requirements and felt, by doing so, that he was
healing both the wounded nature of the child and the sociopathic tendencies
of the “tough guy.” They were engaged eight months later and married a year
after that. There were no more indications of sociopathy although the childlike
“desperation to be loved” returned on occasions. The client was able to have
 Identity 225

some normal fights with his wife but had to be careful not to give away too
much power to her.

First of all, this was a seriously conflicted client with a history of significant
misbehaviors and violations of others. Psychodynamic therapists would
emphasize his narcissism and his sociopathy. As I write this, there has been
a major development in psychology similar to the MPD fad that existed
thirty years ago; this development conceptualizes individuals like this client
as “sex addicts” or “love addicts.” In fact, the girlfriend was warned by her
friends that he needed to attend a thirty-day inpatient treatment program for
sex addiction—and be in an ongoing sexual addiction support group—to have
any hope of changing his poor behavioral choices.
The choice of three parts was, of course, somewhat arbitrary. I could say
that I picked “3” because that seemed the minimum necessary to create a
frame where he could both take responsibility and forgive himself. From
a constructionist point of view, I could have divided the protector part into
two parts: a healthy protector and a sociopathic protector who felt that his
father’s critical behaviors justified his lying and cheating. Of course, I could
have added three or four other parts if I had believed that they would have
contributed significantly to the healing ritual.
This case was chosen to illustrate the ambiguity of constructed reality.
It was also chosen because it seems to have generated good results with a
man who had a truly terrible history of poor choices and poor behaviors.
Are his good behaviors fleeting and ephemeral—doomed to failure because
his core issues of sexual addiction and narcissism have yet to be addressed?
Perhaps. . . . In truth, even if he were behaving well after two years of sexual
addiction treatment and in an ongoing group, a man with this history might
go back to his dysfunctional behaviors at any time.
Why did my more minimalist intervention work? The client’s explanation
is that he felt qualitatively different about this woman: “somehow I just really
love her in a way that I’ve never felt before.” I, of course, jumped on this feel-
ing as a justification of a more minimalist intervention: “given the gravity and
long-term nature of your unethical behaviors around women, most men with
your record would need years of treatment. But the quality of your love is so
profound that it may serve as a significant shortcut—a path to personal trans-
formation that allows you to change rapidly and deeply.” His feeling and my
endorsement allowed and supported the rapid change. If I had responded dif-
ferently, and predicted a long and slow recovery with many setbacks, it seems
likely that the negative prediction would have defined the course of therapy.
Just as significantly, the division of self into three parts, and the understand-
ing that his sociopathic behaviors were emitted by the part that suffered from
his father’s critical behaviors, allowed him to touch his negative behaviors
226 Chapter 10

without being overwhelmed by guilt and shame. Is this a technique? The

previous chapter on reality therapy emphasized that the minimum model
for change consists of asking a client to behave better. Does this chapter on
multiple selves imply that guilt and shame are always present and we always
need to deal with them with dissociation?
Not exactly. The purpose of this chapter is to illustrate that whenever we
move from the unitary self to multiple selves reality is altered. Multiple selves
align with the Abyss and with Dionysian change. Having only a unitary self
implicitly created a dire situation; his poor choices made him the embodiment
of a sexually addicted personality disorder. Staying in the unitary self gives
him only two choices: he can opt for long-term penance for his unethical
behaviors—a penance seasoned with guilt and shame, or he could choose
denial of his issues, leave his girlfriend, and recommit to treating women like
objects. Conversely, going to a multiple-self model changed his reality the
moment he started viewing his choices and misbehaviors from that perspec-
tive. He wasn’t a bad person, he just had a part that had been criticized so
often that it justified sociopathic behaviors. It was only a child part after all. It
hardly knew better. You might have chosen the same if you had gone through
what he went through.
And, in that new perspective, healing quickly was an option. He simply
had to include the ritual behaviors of sincere apologies, generous behaviors
to his mother-in-law and step-daughter, and frequent acts of self-compassion.
Because he was no longer bad at a core level, anything was possible.
In this sense, it is appropriate to argue the a multiple-self model is just as
central to therapy as the direct request to change that is derived from reality
therapy. The purpose of the Net is to stabilize. The purpose of therapy is to
change. The Net only allows licit changes like the adolescent/adult transition.
Most of therapy concerns illicit feelings and behaviors. Staying Apollonian—
staying committed to the unitary self—condemns the therapist and the client
to slow and painful change. Going Dionysian—adopting a multiple-self per-
spective—allows more rapid movement unfettered by the past and by guilt
and shame.
Of course, the approach doesn’t seem strong enough or long enough to
take care of the scope and extent of his confusion and misbehaviors. Note
the Apollonian implications: since the client behaved very badly over a long
time, he will require an equivalently long period of treatment—and prefer-
ably one with lots of painful work—to make up for his mistakes. Sexual
addiction therapy, with its assumption of a humiliating label and its required
confession of “I am a deviant,” will always “feel” like the more appropriate
treatment for such egregious misbehavior. Of course, adopting such an Apol-
lonian perspective—especially if it is adopted unconsciously—will limit the
therapist’s choices and the client’s ability to change.
 Identity 227

Dissociation and multiple selves are one of the easiest concepts to under-
stand—they hide in plain sight in daily life—and yet one of the most power-
ful. The arbitrariness about the number and the nature of the ego states creates
a palpable sense of the fragility and ephemerality of reality. Switching from
the responsible unitary self to the understanding/forgiving nature of multiple
selves effortlessly lightens that Apollonian sense of seriousness and heavi-
ness. And the fact that this can be created so easily is significant. We are
only able to move clients into a multiple-self model so effortlessly because
dissociation is so pervasive in our daily functioning.

THE BASIC MODEL EXTENDED

Re-examine all that you have been told . . . dismiss that which insults
your soul.
—Walt Whitman, Leaves of Grass (1855)

The dissociation approach described in this chapter is a natural complement

to the reframing/reality approach described previously. Reframing is based
on the fluidity of reality; dissociation is based on the fluidity of identity. Fully
understanding and experiencing the concept that reality is constructed does
require understanding the feeling “it’s all made up”; full mastery also requires
understanding the feeling that my Self and identity are enormously fluid and
malleable—in other words, identity is also “all made up.”
If one reflects on the history of human culture, communication, and heal-
ing, it can be argued that there is probably no other practice as effective at
exposing the fluidity of identity as psychotherapy. What other practice or
experience allows an individual to witness the shifting of identity easily and
profoundly multiple times per day? What effect does it have on the conscious-
ness of the therapist to realize that identity can be radically altered simply by
uttering a few sentences? Merely saying, “how does your child part feel when
the angry part is out?” creates a profoundly altered state—in both client and
therapist—in one sentence. Absorbing the implications of how easy identity
can be altered—and the resulting changes in “reality”—is like working in a
laboratory that allows for constant, ongoing experimentation.
There are levels to this understanding. Even an elementary school student
can say that part of me is a “good boy” and another part of me wants to do
whatever I want whenever I want. This kind of identity fluidity is important—
it does ultimately point toward the Abyss—but it is such a common experi-
ence that it fails to be transformative. To gain from the experience of client
dissociation, the therapist must allow every shift of identity to be a potentially
profound event. Even more importantly, they must cultivate the capacity to
228 Chapter 10

communicate this to the client. Returning to the elementary student, simply

acknowledging that he has spoken of his two parts leads to little benefit.
Conversely, the therapist can say, with full concentration and seriousness,
“Well, has the good boy ever had a conversation with the part that does as
he wishes? And in that conversation, did the good boy make any headway at
changing the willful part?”
Simply with this intention, the entire situation is now in play. There is a
good chance that the boy will be able to talk about his willfulness without
being paralyzed by shame, guilt, or defensiveness. Simply with a question—a
question asked with intensity—the door opens for the boy to move forward.
But it requires the therapist to have a depth of commitment to multiple selves.
The boy will know when the therapist is serious and will respond accordingly.
Dissociation also makes an important contribution to the basic model.
Reality therapy postulates that therapy works when a wise and caring practi-
tioner urges a client to move in a healthy direction. Because reality therapy
embraces right/wrong it has a capacity to move hyperstable clients—clients
who are frozen by fear. Some clients, however, resist being moved directly
even through the urging of a wise and caring therapist. For these clients some
form of dissociation is the answer. Fear is markedly reduced when the shame-
based part is seen as “not me.”
It is not a stretch to argue that deep work in psychotherapy is virtually
impossible without some mastery of dissociation. We are all familiar with the
client who is afraid to look inside—to acknowledge and experience some of
his shadow-related feelings. In truth, however, all clients—and ourselves as
therapists—gain much of our ability to move through the world of affect and
the world of the unconscious because we can disassociate. If we had to take
personal ownership for every shadow feeling we encounter, every sojourn
into the subconscious would be a journey filled with terror.
The Apollonian forces will always resist dissociation, of course, at least
at some level. It threatens the Net and summons the sense of the underlying
Abyss. They will argue that “really” there is only one solid client in the room
and that these seeming shifts in identity are simply symptomatic manifesta-
tions of pathology and trauma. This harkens back to Bill Maher’s “bubble” and
Kahnman’s System 1; if we “know” that all people have a unitary self, we will
miss the obvious experience occurring in front of us. And in the missing, we
remain entranced by the Net and mistake constructed for fundamental reality.
Conversely, the Reality B therapist understands that this sense of multiple
identities takes one to the chaotic edge of the Abyss. This is one of the purest
forms of “dancing with the Abyss.” It is achieved fairly effortlessly in that
the client and the therapist can get there with one sentence. When attention
and mindfulness are brought to the process, it enhances both the therapist’s
consciousness as well as her charisma.
 Chapter 11

Heart and Soul

We were together. I forget the rest.

—Walt Whitman, Leaves of Grass (1902)

Affect has a special role in constructed reality. Just as cognitive control

of feelings defines the Apollonian, affective emphasis defines the Diony-
sian. This chapter focuses on what is experienced when the Abyss breaks
through the shelter of the Net. Primarily, these breakthroughs are character-
ized by feelings, typically negative feelings like self-deprecation, anxiety,
and meaninglessness. Working with these breakthrough feelings—shadow
work and soul making—can transform these negative feelings into new
beginnings or even guidance and epiphanies. Apollonians repress and
control feelings; Dionysians cooperate with, listen to, and are transformed
by them.
This chapter will also look at affect from other perspectives. The therapeu-
tic relationship is as dependent on caring and heart as it is on wisdom. Some
therapists particularly focus on working with feelings. Moreover, some of the
Abyss breakthroughs are considered oracular and we will look at one form—
dream work—as a way to work with messages from the Abyss. Finally feel-
ings—and the heart that symbolizes them—are not simply objects, events,
problems, and opportunities, they are also ways of knowing. Many of the
Dionysians featured in this chapter recommend knowing through the heart
over knowing with the head.
But we will begin with an advocate—the Dalai Lama—who sees the two
forces as equivalent and as essential to the therapeutic relationship. In a recent
anthology of Buddhist psychology, the Dalai Lama (2012), in his foreword,
described his sense of the healthy therapeutic relationship as follows.

229
230 Chapter 11

In the Buddhist tradition, there are two qualities seen as essential both to our
own well-being and to being able to be of appropriate help to others. These
are compassion and wisdom. They are said to be like the two wings of a bird
or the two wheels of a cart, for the bird cannot fly and the cart cannot roll with
only one. Compassion involves wishing to free someone else from suffering,
recognizing that she or he wishes to be happy and to avoid distress and misery
just as we do. Wisdom involves seeing things as they are, with clear, open eyes,
appreciating the interdependence and constantly changing nature of people,
things, and events. (p. iii)

In a literal sense, these two factors—wisdom and compassion—are different.

Wisdom implies knowing, being mature, understanding. This is more the left
brain or “head” attribute. Compassion, of course, comes from the heart and is
a right-brain attribute. While this head/heart split is a frequently used typol-
ogy in psychotherapy, the Buddhist psychologists believe that, in truth, the
two are essentially the same and that one flows into the other.

Wisdom and compassion are also inseparable; one simply cannot exist without
the other. Most of us notice that when we have a multilayered understanding of
a patient’s problem, our hearts open. Conversely, when we feel warmly toward a
client, our minds can see many more treatment possibilities. This book explores
how wisdom and compassion comingle at both the relative level—in the day-
to-day experience of psychotherapy—and at the absolute level—in our funda-
mental, unconditioned nature. Depending on our perspective, we may say that
compassion emerges out of wisdom or that wisdom emerges out of compassion,
but either way, these two qualities are indistinguishable at the deepest level of
experience and understanding. (Siegel & Germer, 2012, p. 3)

From this quote, we can see that it is not only important to see clearly but
to be equally open to the guidance of the heart, the emotions, and intuition.
Therapists attempting to understand the nature of constructed reality have to
be guided by feelings as much as discernment. And, of course, all agree that
real therapeutic change is always dependent on heart, connection, and trust.
We should also recall that wisdom and compassion not only describe the
ideal therapist-client relationship, they are also the core components of thera-
peutic charisma. As mentioned above, one of the weaknesses of using the
term, charisma, is that it can become confused with status, fame, and power.
To define it as embodying wisdom and compassion eliminates this confusion.
When speaking of charisma, however, it is important to differentiate the
wisdom and compassion that characterizes the average therapist from the
qualities that characterize the superior therapist. For wisdom, the dividing
line is fairly clear: Apollonian wisdom consists of wisdom about how to
flourish inside the prevailing view of reality; it is expertise in terms of the
 Heart and Soul 231

rules of the Net. Dionysian wisdom sees beyond the prevailing Reality via
willing immersion in the Abyss; it is the ability to discern between the con-
structed and the fundamental. The superior therapist encompasses both types
of wisdom; the average therapist primarily embodies the Apollonian.
The dividing line for compassion is similar. On the surface, both the aver-
age therapist and the superior therapist have caring, compassion, and good
will toward their clients. We perceive suffering and sorrow all around and
move toward clients and others with kindness and concern. The superior
therapist, however, moves beyond this perspective and practices compassion
from a stance at the edge of the Abyss. Becker tells us we are all going to
die. That fact makes our lives meaninglessness and contributes to the sense
that we are essentially alone. The compassion of the superior therapist incor-
porates the implicit despair of the Abyss and, like Buber, continues to choose
connection in place of alienation.
It is difficult to discern between average compassion and superior com-
passion. Martin Buber, fortunately, wrote a book, I and Thou (1970), which
focuses explicitly on this discernment. Here is a quote from that work.

When I confront a human being as my Thou and speak the basic word I-Thou
to him, then he is no thing among things nor does he consist of things. He is no
longer He or She, a dot in the world grid of space and time, nor a condition to
be experienced and described, a loose bundle of named qualities. Neighborless
and seamless, he is Thou and fills the firmament. Not as if there were nothing
but he; but everything else lives in his light. (p. 59)

Buber believes that most of the time, humans relate to the objects in the world
as “things.” He calls this the “I-It” relationship. This is a condition of alien-
ation, fear, distance, and separation. It embodies the kinds of connections
that are part of the Net. Buber contrasts this world of objects with the world
of relationship. In spite of our apparent existential alienation, everything is
actually in dialog—there is a connection running through everything. Partici-
pating in this reality requires an action—“speaking the basic word “I-Thou.”
For Buber simple perception always belongs to the world of I-It; it is only
when we extend that we have the opportunity to actualize the relationship.
This action transforms reality—it participates in the oracular aspect of the
Abyss and then “everything else lives in his light.”
Discernment is the key. With wisdom, the awareness of the constructed
nature of social reality is the basic metric. Buber’s definition allows us to
reach for a similar level of consciousness with compassion—it allows us to
check the quality of our compassion using I-It versus I-Thou.
Psychology also has a special contribution to make in this area in the form
of the development of attachment theory. It is somewhat hard to believe
232 Chapter 11

that this theory was ever in dispute as, in hindsight, it seems so reason-
able to assume that children that are provided with a safe environment for
attachment—an environment which provides security, affective regulation,
and appropriate stimulation and exploration—would be better off than rela-
tively impoverished children. Theorizing that children who lacked healthy
attachment in childhood would have difficulties connecting to others as
adults seems obvious. But the situation became even more compelling when
neuroscientists began to look at attachment. Their first question that arises
neurologically from attachment theory focuses on functionality: since human
brain development continues for many years after birth, does poor attachment
suggest poor brain development? Is there literally lasting brain damage in
humans raised in poor attachment situations?
The neuroscientist who is perhaps most identified with these questions is
Alan Schore. He has not only provided neuroscientific support validating the
centrality of attachment theory for brain development, he has extended that
work to look at the implications of attachment theory for the psychothera-
peutic process in general. Differing from the Dalai Lama, Schore apparently
believes that when it comes to therapeutic healing, “heart” is more important
than “head.”

An attachment-based clinical approach highlights the unconscious nonverbal

affective factors more than the conscious verbal cognitive factors as the essen-
tial change process of psychotherapy. Thus, at the most essential level, the inter-
subjective work of psychotherapy is not defined by what the therapist does for
the patient, or says to the patient (left brain focus). Rather, the key mechanism
is how to be with the patient, especially during affectively stressful moments
(right brain focus). (Schore, 2012, p. 44)

The heart is not simply a basis for intervention and connection, it also has its
own epistemology—its own way of knowing. This knowing is referred to by
various names—intuition, gut feelings, felt sense—and it is independent from
the cognitive epistemologies. Antoine de Saint-Exupery particularly lauds the
heart’s way of knowing: “And now here is my secret, a very simple secret:
It is only with the heart that one can see rightly; what is essential is invisible
to the eye” (2000, chapter 21). Pascal agrees and states: “The heart has its
reasons which reason knows not” (Kegan, 1885, p. 307).
Sometimes the heart and head support each other; at other times, they are
in conflict. Heart knowledge is more Dionysian; the head embodies the Apol-
lonian approach. Heart material seems more unconscious and it is difficult to
trace its antecedents. Like most Dionysian approaches, it is more numinous
because it feels less under conscious control. Rainer Maria Rilke agrees and
states, “Our heart always transcends us” (as cited in Gilbertson, 2014, p. 200).
 Heart and Soul 233

And, finally, Noah Benshea believes: “My heart knows what my mind only
think it knows” (as cited in Mejabi, 2016, p. 59).
In spite of the Dalai Lama’s assertion that heart and head are equivalent
and that they meet in the depths of the soul, most of the quotes above urge
us to understand the unique contributions of the heart. It seems likely that an
understanding of this uniqueness is a necessary preliminary step before the
ultimate unity of the two principles can be fully understood.

NEUROSCIENCE AND THE

HEART-TO-HEART CONNECTION

All love is expansion, all selfishness is contraction. Love is therefore

the only law of life. He who loves lives, he who is selfish is dying.
Therefore love for love’s sake, because it is the only law of life, just as
you breathe to live.
—Swami Vivekananda, The Complete Works
of Swami Vivekananda (1907)

Schore began his neuroscientific quest to understand the “heart” or right-

brain aspect of the therapeutic relationship by exploring the neuroscience of
attachment theory. He is particularly famous for his theory of affective regu-
lation. This theory postulates that a person who has attachment deficits when
young fails to develop the requisite ability to regulate their own feelings. His
research demonstrates that the effects of early abuse and neglect essentially
inhibit the development of the right brain which leads to a propensity to
develop problematic behaviors and mental health disorders later in life.
Essentially Schore is arguing that the child’s brain requires healthy attach-
ment—primarily to the maternal figure—in order to develop appropriately.
Without this healthy attachment, the evolving person essentially has “brain
damage” when it comes to regulating his own affect. Fortunately Schore is
optimistic and supports the concept of neural plasticity—the brain can con-
tinue to develop even much later in life. And, not surprisingly, he sees the pro-
cess of therapy as the ideal opportunity to accomplish that kind of repair work.
When discussing effective therapy, however, Schore introduces a new con-
cept. Therapy can be done from a right-brain/primal process point of view or
it can be done from a left brain/verbal perspective. Since Schore believes that
the trauma is centered in the underdeveloped right brain, he recommends a
“right brain-to-right brain” emphasis in therapy.

Implicit right brain–to–right brain intersubjective transactions lie at the core of

the therapeutic relationship. They mediate what Sander (1992) calls “moments
234 Chapter 11

of meeting” between patient and therapist. Current neurobiological data suggest

that “While the left hemisphere mediates most linguistic behaviors, the right
hemisphere is important for broader aspects of communication” (van Lancker
& Cummings, 1999). . . . (J)ust as the left brain communicates its states to other
left brains via conscious linguistic behaviors, so the right brain nonverbally
communicates its unconscious states to other right brains that are tuned to
receive these communications. Regulation theory thus describes how implicit
systems of the therapist interact with implicit systems of the patient; psycho-
therapy is not the “talking” but the “communicating” cure. (Schore, 2012, p. 39)

Schore’s extension of attachment theory postulates that all humans are

aware of this right brain-to-right brain relationship because this is the same
mechanism used by parents—especially mothers—during the developmental
process. The infant and young children are unable to self-regulate their own
affect. The right-brain-connected mother responds to this deficit by creating
an environment of safety. When the infant is stimulated—and especially
when the child is overstimulated or stressed—the maternal connection func-
tions to regulate his excessive affect, and models to the child ways to handle
uncomfortable feelings. Initially, the parent holds/modulates the child’s feel-
ings for him and later his developing right brain learns to do it on his own.
Schore believes that this same holding and modeling process is at the heart
of psychotherapy. Therapists and mothers develop the capacity to make this
right-brain connection via their own ability to live productive lives and their
own abilities to regulate affect. Interestingly, he proposes that this process
is unconscious both for the mothers/therapists and for the infants/clients. In
support, Schore cites certain mother-infant studies where the mother begins
to respond to infant needs in less than 130 milliseconds, an interval that is so
short that it precludes conscious deliberation. In sum, the unconscious/primal
nature of the right brain-to-right brain connection clearly differentiates this
process from the more cognitive, verbal, and conscious left brain form of
psychotherapy.
Unfortunately, in situations where the maternal bond was inadequate, the
adult client lacks the ability to handle life stressors without experiencing
some type of decompensation. When this kind of client enters therapy, his
minimal requirement for progress depends on the therapist-client relation-
ship’s ability to recreate the environment of safety that was absent in child-
hood. As the client discusses traumatic events, the healing relationship with
the therapist replaces the dysfunctional maternal relationship; this healing
relationship is capable of regulating client affect and eventually results in new
and more functional neural pathways in the client’s brain.
Clearly Schore is discussing the “compassion” side of the therapeutic
relationship. Somehow the right brain of the therapist signals to the right
 Heart and Soul 235

brain of the client that they will be safe and secure in the therapeutic environ-
ment. This is often experienced by the therapist as an openhearted presence
with the client. Conversely the client senses the unconditional availability of
the therapist and the implicit permission to lean into that space. Siegel and
Gerner, who are Buddhist psychologists with a research focus on developing
compassion, agree with Schore that there can be a neuroscientific description
of compassion. Note the similarities between how they see the right brain-to-
right brain relationship and how Schore describes it.

Neuroanatomically, social emotions like compassion engage regions in the brain

well below the cortex, including the hypothalamus and the brain stem, that are
associated with basic metabolic processes and evolutionarily old emotions such
as fear (Immordino-Yang, McColl, Damasio, & Damasio, 2009; see also chap-
ter 8). Compassionate brain states also appear to activate the mesolimbic neural
system, which may explain why compassion is intrinsically rewarding (Kim
et al., 2011). The fight–freeze–flight and competition–reward subsystems in the
brain are balanced by a “safeness” subsystem (Depue & Morrone-Strupinsky,
2005; Gilbert, 2009b; see chapter 18). The safeness system is associated with
compassion—caregiving and soothing—and appears to be related to the neu-
rotransmitters oxytocin and vasopressin.
Compassionate mind states are typically calming and are characterized by
decelerated heart rate (Eisenberg et al., 1988), lower skin conductance (Eisen-
berg, Fabes, Schaller, Carlo, & Miller, 1991), and vagus nerve activation (Oveis,
Horberg, & Keltner, 2009; Porges, 1995, 2001)—the opposite of what occurs in
sadness and distress (Goetz et al., 2010). We also have mirror neurons that contin-
ually register what others are thinking and feeling (Rizzolatti & Craighero, 2004;
Rizzolatti & Sinigaglia, 2010; Siegel, 2007), prompting us to relieve the suffering
of others to make ourselves feel better. Finally, it appears that many individuals,
especially women, have a “tend and befriend” response to stress, rather than fight
and flight (Taylor et al., 2000). In sum, numerous elements in our nervous system
predispose us to feel compassion. (Siegel & Germer, 2012, pp. 18–19)

Client recognition of this client-therapist bond is primarily unconscious

although it may eventually rise to conscious awareness. It may occur rap-
idly or even instantaneously. Recall the rather shocking provocative therapy
examples from Farrelly, where he moved quickly and in a socially inappro-
priate manner; such movements are only possible if he has somehow con-
nected to the client so profoundly that the client feels the compassion in spite
of the provocative words.
Schore explains these kinds of results by referring to primary process
communication. He believes that primary process is essentially a nonverbal
communication consisting of items like tone, posture, facial expressions, and
so on. The right brain of the therapist conveys its presence via these sorts of
236 Chapter 11

communications to the right brain of the client which is designed to receive

them. Schore is arguing that it matters little what one says; rather, the thera-
pist’s presence and ability to connect to the client on a preverbal level is the
most important factor in healing.
Finally, Schore takes an initial look at what is happening inside the right
brain of the gifted therapist that enables her superior results. The following
quote, which describes therapeutic intuition, is strongly reminiscent of the
Rilke and Benshea quotes above which praise the superior wisdom of the heart.

With regard to implicit cognition, I have recently suggested that primary process
cognition underlies clinical intuition, a major factor in therapeutic effective-
ness (Schore & Schore, 2008). Indeed, the definition of intuition, “the ability
to understand or know something immediately, without conscious reasoning”
(Compact Oxford English Dictionary of Current English, 2005), clearly implies
right and not left brain processing. Psychological theoreticians now assert that
intuition depends on accessing large banks of implicit knowledge formed from
unarticulated person—environment exchanges that occur between environmen-
tal input and the individual’s phenomenological experience (Narvaez, 2010).
It operates on a nonverbal level, with little effort, deliberation, or conscious
awareness, and is thus characterized as “phenomenally unconscious.” (Schore,
2012, pp. 122–123)

Schore is a strong advocate for the unconscious, nonverbal, heart-centered

aspect of psychotherapy. He makes a compelling case that the initial “instruc-
tions on how to be human” which occur between mother and infant are the
correct metaphor for therapeutic relationships in adults. Finally with his invo-
cation of therapeutic intuition, he aligns himself with the quotes above which
refer to the innate/superior wisdom of heart over head.
Interestingly, in his discussion of right-brain attributes, Schore includes
implicit references to Kahneman’s System 1.

In fact the right brain appraisal of safety or danger in the social environment is
essentially performed implicitly at very fast time frames below conscious aware-
ness (see Schore, 2003b, 2004, 2005). Thus, cognition also refers to the right-lat-
eralized social cognition of face processing, which in a relational intersubjective
context allows for the appraisal of exteroceptive social cues. In addition, intero-
ceptive sensitivity (Barrett, Quigley, Moreau, & Aronson, 2004)—the tracking
of somatovisceral information coming up from the body—is also a cognitive
process. Both of these cognitive functions are operations of the right hemi-
sphere, the locus of implicit learning (Hugdahl, 1995). (2012, p. 291)

Kahneman, of course, agrees that the appraisal of danger is done quickly and
holistically. If you put together Schore and Kahneman, it is possible to argue
that right brain-to-right brain bond is equivalent to a System 1-to-System 1
 Heart and Soul 237

connection. In this sense, Schore is recommending that the System 1 of the

client, which is prone to experience danger in many social environments, can
be held, calmed, and soothed via exposure to the System 1 of the therapist.
The calmness in the face of real-world challenges moves directly from the
unconscious of the therapist to the unconscious of the client—a right brain-
to-right brain connection.
The rapid and unconscious nature of the right brain-to-right brain connec-
tions make it appear that the therapist either has it or doesn’t have it—he is
either gifted at unconsciously creating this kind of bond or not. Fortunately
the situation is not quite this simple. Therapists are familiar with the sense
that they are effectively connected to one client and unable to connect to
another. Similarly, even when they have a good history of connection with
a certain client, they can become confused or threatened, and “close their
hearts” to that client. For example, in the following quote, Gerner describes
a situation with an old client who has returned to therapy after a series of life
reversals. Note how Gerner becomes aware that he has lost his relationship
with the client and what he does to repair it.
Ethan was a middle-aged, previous client who returned to therapy during a
life crisis consisting of divorce, financial stress, failing business, and loss of
a house. He had the full spectrum of depressive symptoms including insom-
nia, weight loss, suicidal ideation, and anhedonia. His medications were no
longer helping.

I had known Ethan for almost 10 years and had never seen him in such a state.
Our previous pattern had been to brainstorm together about his life problems.
But this time I became frustrated because each question I raised was met with a
web of problems that rendered it meaningless. Eventually Ethan stopped me and
asked if I had grown tired of him. He added plaintively, “I know we’ve known
each other for almost a decade, but have you stopped liking me?” That’s when
I slowed down and took the time to just be with Ethan—and to be with myself.
I gave up the rush to fix him and prevent a possible suicide, to avert foreclosure
on the home his wife was living in, or to keep him from becoming emotionally
disabled. I said to myself, “This is the only moment of our lives, no matter how
painful it may be. It’s just Ethan and me.” I allowed myself to enter Ethan’s
reality and let his pain become my own.
When I did that, I began to realize how overwhelmed I was feeling and how
incapable of helping Ethan I felt. I suspected that Ethan was feeling exactly the
same way. Our conversation became much simpler:
ETHAN: I don’t know what to do.
CKG: Neither do I. Certainly not now.
ETHAN: I’m really alone here— no wife, no job, nobody.
CKG: It’s pretty bad, I know.
ETHAN: I’m just so overwrought. I wake up in terror.
238 Chapter 11

CKG: Terror?
ETHAN: Mostly about money, how I’ll survive.
CKG: Can you feel the terror in your body?
ETHAN: Definitely . . . here in my belly. I wake up with a knot in my stomach
almost every morning.
I had suspected that Ethan felt fear in his belly because I was feeling the same
sensation at the time. As Ethan spoke about his experience, I waited for the
muscles in my abdomen to relax—to stop resisting— before I felt ready to
return to the subject of how Ethan could safely get through the day. Ethan beat
me to it. He stopped calling himself a “complete failure” and wanted to discuss
how to stay out of the hospital by nourishing himself with regular meals and
going to bed when he felt tired. . . . When Ethan made me stop and pay attention
to my own experience in this way, the therapy began to move forward again, this
time with much less effort.
Compassion is a skill that allows us to open to sorrow. When we resist the
sorrow that arises in our own lives, or fight the pain we feel for others who are
suffering, we cannot be compassionate. In the case of Ethan, I was grieving
that his life was falling apart, I was afraid he would commit suicide under my
watch, and I was vainly trying to recreate the happier times we’d had together
in the past. I simply wasn’t willing to feel fear and sorrow, both his and mine.
(Germer, 2012, pp. 94–95)

This case study suggests that when the therapist gets off center, a “deep
breath” and reflection on the possible presence of fear should be the first step.
Clearly Germer had lost his ability to establish Schore’s right brain-to-right
brain relationship although he had experienced it regularly with Ethan in the
past. Fortunately he was able to reestablish it fairly easily once he became
aware of his level of attachment to outcome.
Germer reports that he was feeling grief, a need to fix Ethan, fear about
the suicidal ideation and a general sense of being overwhelmed. This is
a common state experienced by therapists as they work with the liminal
members of our culture—clients that exist near the edge of the Abyss. As
mentioned earlier, it is tempting in such situations to distance ourselves from
our discomfort by judging these clients, or diagnosing them, or using some
other means of protecting ourselves from the anomic feelings they engender.
Germer makes that most difficult of therapeutic maneuvers: turning to face
fear and softening toward it when every cell in our body pushes us to fight
it or run from it.
Germer’s example is, of course, excellent therapy. Moreover, from a
Schore perspective, it provides a concrete example of how to reestablish the
right brain-to-right brain relationship. It documents that such relationships
are fluid and come into and go out of existence. These relationships are not a
 Heart and Soul 239

“you can do it or you can’t” kind of thing. They are available in each moment
of therapy. Unfortunately, without mindfulness, these relationships can also
be lost in the next moment of therapy.
Schore’s work provides a different perspective on the development and
manifestation of heart and compassion. Perhaps most importantly, by sup-
plying a neurobiological explanation for heart, Schore makes the sense of
connection more real, more basic and more achievable. The concept of a right
brain-to-right brain connection implies that to be human is to be connected.
Moreover, it suggests that focusing on alienation and responding effectively
is a basic act in psychotherapy. It implies that we all have an awareness of our
level of connection to each other and an assessment of the degree the other is
safe, helpful, beneficent or the opposite.
Notice just how many quotes in this chapter laud the superiority of
heart over head, of wisdom over compassion. Clearly the Dalai Lama,
with his commitment to the equivalence of the two, disagrees. But recall
that Western culture is in the midst of a battle between the Premodern and
the Modern, between the faith of spiritual revelation and the rationality
of the scientific model. Given that the entire culture leans to the right—
toward the rational, the empirical, the scientific, and the verbal—is it any
wonder that so many deep Western thinkers urge us to emphasize the
heart.
In this spirit, Schore points out that certain kinds of abilities are only avail-
able to therapists who prioritize heart over head.

Attachment studies strongly support Panksepp’s (2008) bold assertion of the pri-
macy of affective neuroscience: “Now cognitive science must re-learn that ancient
emotional systems have a power that is quite independent of neocortical cognitive
processes” (p. 51). In other words, what is learned cognitively and stored in the
left hemisphere has little to do with the affective relational, two-person experi-
ences stored in the right hemisphere. Clinicians can only assess these patterns
through their own implicit right brain connections with their clients, that is, by
accessing their own bodily-based instinctive responses. (Schore, 2012, p. 400)

Finally, it should be obvious that Schore’s work has implications for the
concept of charisma. Virtually every use of “heart” in the section above can
essentially be replaced by “charisma.” The perception of charisma is a right
brain-to-right brain experience. Heart helps a client be safe and to regulate
dystonic affect; charisma does the same but also works to help a client resolve
issues by accepting explanatory mythology and transformative rituals. Rec-
ognition of the therapist as a key individual with the right to define reality is
a right brain-to-right brain experience.
240 Chapter 11

LOVE AND THERAPY

One cannot be spiritual as long as one has shame, hatred, or fear.

—Ramakrishna, The Gospel of Sri Ramakrishna (1910)

Returning to the chapter on therapeutic wizards: charisma is dependent on

the client feeling that the therapist has access to the “secret knowledge,” a
knowledge that is “divinely bestowed,” a knowledge that “licenses” the thera-
pist as a key individual who can change a client by will and suggestion. This
secret knowledge is both left brain—discerning the real from the unreal—and
right brain—a preverbal and unconscious manifestation of heart connection.
Charisma is as dependent on the ability to make a provocative and radical
heart connection as it is dependent on the sense that the therapist has access
to “the secret.”
The following clinical examples are attempts to tell stories that illustrate
this level of radical connection. Since heart is present in virtually every
clinical interaction, and especially because heart connection is dependent on
a right brain-to-right brain recognition, it is difficult to pull out case examples
that are “pure heart” or “have more heart.” That said, the following vignettes
were chosen because they “feel” like such beautiful examples of the therapists
connecting and loving. With that, let us move to our first clinical example, a
conjoint therapy vignette from Richard and Antra Borofsky (2012).
Carl and Patricia have two children and have been married for six years.
Patricia is a stay-at-home Mom and Carl works for a tech company and trav-
els often. They have not had sex for over two years and the relationship is
obviously strained.

RICH: I would like to ask you to please look at each other for a moment. (pause)
Please look for a few seconds and notice how this feels.
CARL: (to us) It feels uncomfortable.
ANTRA: Could you please tell this to Patricia?
CARL: (after a short pause, looking nervously and hesitantly at her) I feel awk-
ward looking at you. It’s uncomfortable.
RICH: Where in your body do you feel the awkwardness?
CARL: (to Rich, looking confused) What do you mean?
RICH: Do you feel the awkwardness in your face, in your chest, or somewhere
else? . . . Letting her see how you feel uncomfortable, will help her start to under-
stand and care about what it’s like for you.
CARL: I’m feeling how painful it is that we’ve become such strangers. (Looks
away for a few seconds and then looks back at Patricia.) My face feels all stiff.
Kind of like a mask. (pause) Now I’m feeling a lump in my throat.
 Heart and Soul 241

PATRICIA: (beginning to tear up) I have been so angry at you because I have
needed you and you haven’t been there.
ANTRA: (kindly) Patricia, are you feeling angry right now?
PATRICIA: (slowly to Antra) No, not right now. (pause) No . . . right now, I’m
feeling sad.
ANTRA: Please let him see your sadness. (pause) Can you see him seeing how
you are sad right now?
PATRICIA: (looking at Carl while crying softly) I miss you. I really miss you.
CARL: (Silently and slowly reaches over to hold Patricia’s hand.)

Later Antra instructs the couple on a couples exercise using a stone egg.
She asks them to pass it back and forth without speaking but with a solemn
attitude—as if passing something of importance. Passing the egg, the silence
becomes more concentrated as they become aware of how they are giving and
receiving. Rich then asks them to share with each other how they have been
struggling in the marriage as they continue to pass the egg back and forth.

PATRICIA: I resent that so much of the burden of caring for our children falls on
me.
RICH: (to Carl) See if you can open yourself to receiving this. Even if this is pain-
ful to hear, see if you can hold this with her. If you are willing, please say, “yes.”
This “yes” lets her know your willingness to hear and let in how it is for her and
to let it sit side by side with how it is for you. This doesn’t mean that you agree or
see the situation the same way she does.
CARL: Well . . . Maybe . . . (pause) well, OK . . . yes . . . I can hear this. I can hold
this with you. (Closes his eyes, takes a deep breath, and after a long pause looks at
Patricia and reaches for her hand, gently putting the egg in her palm.) I am afraid
that no matter what I do, it won’t be enough. I feel like a failure.
ANTRA (to Patricia) Please let him know if you’re willing to hold this feeling
of being a failure with him.
PATRICIA: (letting this sink in) Yes. I’m willing to hear this. (pause) As long as
you aren’t blaming me. So, yes, I’m willing to hold this with you. (Now holds the
stone that Carl gave her in both her hands, next to her chest.) (pp. 284–288)

This vignette is an example of working directly with a heart-centered per-

spective. The Borofskys are implicitly suggesting to the clients that fully
and completely accepting and experiencing feelings is a path that will lead
to healing and, ultimately, to a level of freedom, authenticity, and love. They
are conveying this concept indirectly, through their own nonverbals of calm-
ness, compassion, acceptance, and support. They do not give a lecture about
the importance of these concepts; rather, they live them to their clients—they
implicitly manifest them.
242 Chapter 11

Emotional work is always more sacred, more frightening, and less predict-
able than cognitive work. Emotions are symbolized by water and the chaotic
nature of the Abyss is often portrayed as an uncharted and undifferentiated
ocean. Emotions are connected with the “left hand of darkness” to use a
phrase made famous by Ursula Le Guin. Emotional work tends to embody
a ritual and a rite of passage; moving through the experience leaves one
transformed.
Therapists who work with emotions effectively—like the Borofskys—are
denizens of sacred space. Not only are they unafraid of affect, rather, they are
like snake charmers, special people who have the power to touch and handle
that which is threatening to most of us. As individuals who can touch the
untouchable—the dangerous and forbidden—they have a kind of numinous
glow.
Obviously they are using techniques in working with this couple. Initially
they teach the couple how to communicate their feelings directly and how
to accept them. Next they do a trust building exercise with the stone egg.
Although these techniques are present, they are not the active ingredient
that creates the movement in Carl and Patricia. Instead, Rich and Antra are
modeling how they accept and hold emotions. The couple’s vulnerability is
sustained and made safe by the fundamental loving and accepting qualities
embodied by Rich and Antra. Moreover, they simply “ask” the clients to
respond in certain ways—for example, to hold an emotion without judgment
and to share something threatening—and the clients comply. Schore would
say that there is a right brain-to-right brain connection.
The clients are in an altered state similar to a hypnotic trance. When Rich
asked Carl to look directly at Patricia and face their conflict, and then when
he asked Carl to turn his anxious emotions into somatic feelings, an expert
on hypnosis would argue that Rich was performing a trance induction. Patri-
cia’s ability to do the same, to take a statement and connect it to her body
(the tears), demonstrated that she was completely altered as well. Later, the
exercise with the egg yielded identical results. Rich and Antra modeled how
to be altered with the egg and the couple quickly went into a trance when
they used it as well.
This work is classically Dionysian, not only because the clients are in an
altered state, but because they experience that “pop” or disconnection from
the Net as they move from one state to another. An equivalent Apollonian
intervention might be asking them to give each other two compliments per
day. This is a kind and positive intervention but will not result in the “pop”
achieved by the Borofskys relatively radical intervention.
While the remainder of the therapy session is not included, the Borofskys
do use the last half of the article to articulate the principles underlying their
approach. From this, one can imagine that the Borofskys interpreted the
 Heart and Soul 243

implications or meanings of the session to Carl and Patricia; they probably

made the case that now that they have been vulnerable, now that they have
reacted to their fear with courage and compassion, they are well positioned to
have a love-centered marriage that is functional and generative. In this we see
the classic Reality B framing approach: “now that you have passed through
this effective ritual, you are free to change (you must change) in the direction
of health and healing.”
The Borofskys used simple techniques which are readily available to most
therapists who are taught to explore and validate feelings. The techniques
did not create the outcome; in the hands of a lesser therapist, this feelings
exploration session would have been far less impactful. But in the hands of
charismatic therapists, the clients were persuasively invited to behave in a
manner cued by the therapists and experience tears, a wish to support each
other, and mini-epiphanies of how they had missed each other and wanted
nothing more than to give and receive love and support.
Our second example comes from Stephen Levine and takes place at a
workshop.

In a workshop some years ago during a grief exploration focused on distrust

and fear, a fellow stood in the back of the room and walked hesitantly down the
aisle toward the podium. He was growling that this was not the world we could
trust. His footsteps were heavy and his tone very frightened and angry. As he
approached the front of the room one could sense a rising fear in some of the
participants who viewed this person as “something of a madman and a danger.”
The group belly had tightened.
Swinging his head from side to side, as if expecting an ambush, his frightened
heart screamed, “you can’t trust the world! It out to get you! You got to be ready
to fight!” As he approached closely enough for our eyes to meet, I said to him,
“I’m glad you came here. This is a good place to work. You know, you’re like
someone wearing a bulletproof vest.” Stopping, he pulled up his sweater, “I’m
not like someone with a bulletproof vest. I am someone with a bulletproof vest.”
Beneath his shirt was displayed the shiny gray Dacron of his trembling heart’s
defenses. “But,” he asked me, “what am I to do about armor-piercing bullets?”
To let down his guard would have been, for him, to step off the edge of the flat
world. There was no safety anywhere. He was terrified Narcissus seeking to
protect the armoring of the heart from being penetrated.
It was clear that only kindness would do. Anything “rational” I might have
said would’ve just fed into the well-established paranoia of his grief. Calling a
“bathroom break” for the workshop, I walked a dozen feet to where this fellow
stood, shaking. As I went to put my arms around him, he stiffened. But when I
whispered, “the arms of the mother are always around you, all you need to do
is put your head on her shoulder.” He began to sob. His armoring broke and his
enormous heart exposed itself. He was the personification of our grief, seques-
tered layer by layer over the heart. He was all the parts of ourselves we have
244 Chapter 11

armored ourselves against. His bulletproof vest was a cast for his broken heart.
He was the wounded Angel of us all. (Levine & Levine, 1996, pp. 112–113)

The boldness of Levine’s intervention in this instance was remarkable. This

was not a logical intervention. It was decided by the heart and carried out
through the heart. One can imagine the effect on the frightened man; he
manifested all of his darkness and was met in love and transformed in love.
Levine’s wonderful response epitomizes so many heart interventions.
There is the sense of pain and confusion in the client. There is an overt or
covert message that they exist outside of the possibility of connection and
compassion. There is the movement toward the person by the therapist—fully
aware of the dangerous possibilities of the moment but manifesting a spon-
taneous courage. There is initial resistance where the therapist needs to stay
the course and remain aligned with the heart. Finally there is the breakthrough
where the armor is pierced, the dam bursts, and all the loneliness and hope-
lessness pours out. This is the essence of heart-centered therapy. This is what
Schore means by the right brain-to-right brain connection.
One can certainly imagine the altered state in the client. He might have
chosen to push Levine away, or could have discounted his hug as “touchy
feely”; instead, he accepted it. In accepting it, he was catapulted out of his
reality of being an unlovable person in an immensely dangerous world. In
accepting the hug and the love it implied, he radically recreated his connec-
tions to the Net and his reality.
The final example consists of a famous story about Martin Buber’s encoun-
ter with a student. The story credits this experience as central to Buber’s
insistence on making relationship and connection central to his own path and
to his teachings.

Buber had been upstairs in his rooms meditating and praying one morning, fully
engaged in deeply religious intensity, when there was a knock at his front door
downstairs. He was taken out of his spiritual moment and went down to see who
was at the door. It was a young man who had been a student and a friend, and
who had come specifically to speak with Buber.
Buber was polite with the young man, even friendly, but was also hoping to
soon get back to his meditations. The two spoke for a short time and then the
young man left. Buber never saw him again because the young man was killed in
battle (or perhaps committed suicide, the story is not entirely clear). Later, Buber
learned from a mutual friend that the young man had come to him that day in
need of basic affirmation, had come with a need to understand his life and what
it was asking of him. Buber had not recognized the young man’s need at the time
because he had been concerned to get back upstairs to his prayers and medita-
tion. He had been polite and friendly, he says, even cordial, but had not been fully
present. He had not been present in the way that one person can be present with
 Heart and Soul 245

another, in such a way that you sense the questions and concerns of the other even
before they themselves are aware of what their questions are. “Ever since then,”
says Buber “I have given up the sacred. Or rather it has given me up. I know now
no fullness but each mortal hour’s fullness” of presence and mystery. The Mys-
tery, he says, was no longer “out there” for him, but was instead to be found in the
present moment with the present person, in the present world. (Goldberg, 2011)

And so, charisma is as dependent on heart as it is on head. Given the nature

of empirical Western thought, many writers and teachers elevate right brain
over left when it comes to therapy and healing. The Dalai Lama—with his
teaching about the equivalence of the two—is almost certainly right in the big
picture, but when a therapist is considering her own personal development,
Buber’s advice about the primacy of heart is of great value.

SOUL MAKING

Whoever fights monsters should see to it that in the process he does

not become a monster. And if you gaze long enough into an abyss, the
abyss will gaze back into you.
—Friedrich Nietzsche, Beyond Good and Evil:
Prelude to a Philosophy of the Future (1907)

One of the primary purposes of the Net is to shield us from the entropic, ter-
rifying, and destructive properties of the Abyss. Regardless of the strength
of the Net, the Abyss always breaks through. Sometimes the breakthroughs
are external such as illness and aging, sometimes they are social such as
divorce or job loss, and sometimes they are internal such as anxiety attacks
and depression.
The internal breakthroughs—that is, psychological symptoms—are expe-
rienced as alien and independent. The apparent independence of such symp-
toms led psychology to postulate the existence of the unconscious mind,
a part of the psyche that lies outside conscious control. Psychology has
responded to this often terrifying and self-destructive part of the psyche by
developing a myriad of approaches designed to control it, understand it, and
minimize its negative impact.
Experientially and symbolically the unconscious mind is equivalent to the
Abyss. Both are overwhelming and both attempt to overthrow the control
of the ego. The preferred strategy for both is often denial—Becker’s denial
of death outwardly and the individual’s denial of primal feelings inwardly.
It takes courage to explore each one. Finally, there are promises that such
exploration will eventually uncover the oracular and harmonious qualities
246 Chapter 11

implicit in the unconscious. Many depth psychologists, in agreement with the

epigraph above, promise that the exploration of the unconscious will lead to
an awakening—a day-break.
This book has already outlined two main paths that lead to an experience
of the Abyss. The constructionists and the spiritual seekers tell us that decon-
structing our social programming leads to the edge of the Abyss. The heart-
centered healers tell us that choosing connection versus alienation at the most
challenging life moments leads to the same place. Now we have the depth
psychologists—Jung, Hillman, Campbell, and a host of others—promising
that an exploration of the unconscious, and particularly, an exploration of
painful affective breakthroughs, leads to the same goal.
Hillman, for example, elevates the meaning of these breakthroughs to the
highest level; he calls the process of dialog with the unconscious and the
Abyss-related breakthroughs “soul making” and even believes that the essen-
tial functioning of the psyche requires a kind of “pathologizing.”

The psyche does not exist without pathologizing. Since the unconscious was
discovered as an operative factor in every soul, pathologizing has been recog-
nized as an inherent aspect of the interior personality. (Hillman, 1997, p. 70)

The unconscious mind is a dark place, dangerous, uncharted, and full of demons.
It is the shadow side of the conscious mind—the place where the power of the
ego holds no sway. The nature of the unconscious is always described meta-
phorically. How can it be otherwise when, by definition, it is out of view of the
conscious mind? This is important enough to be repeated: because it is com-
pletely out of view, all definitions of the unconscious mind are constructions
and metaphors, most of which incorporate the concept that the unconscious is
the opposite of the qualities of the conscious mind. It is dark instead of light; it
is chaotic as opposed to ordered; and its meanings are hidden instead of appar-
ent. As an example, examine this summary of Jung’s definition of the shadow.

The shadow, said celebrated Swiss psychiatrist C. G. Jung, is the unknown

“dark side” of our personality—dark both because it tends to consist predomi-
nantly of the primitive, negative, socially or religiously depreciated human emo-
tions and impulses like sexual lust, power strivings, selfishness, greed, envy,
anger or rage, and due to its unenlightened nature, completely obscured from
consciousness. Whatever we deem evil, inferior or unacceptable and deny in
ourselves becomes part of the shadow, the counterpoint to what Jung called the
persona or conscious ego personality. (Diamond, 2012)

The unconscious is full of everything we fear, everything we reject, every-

thing we do not understand, and everything that shames us. Little wonder that
it is impenetrable.
 Heart and Soul 247

That said, there is general agreement among all depth psychologists that
knowing one’s shadow, deciphering its messages, and being open to its feed-
back is one of the primary keys to a successful human life. Jung believes that
“(u)ntil you make the unconscious conscious, it will direct your life and you
will call it fate” (as cited in Wernik, 2016, p. 171). And, in an even more
serious warning, he comments:

A man who is unconscious of himself acts in a blind, instinctive way and is in

addition fooled by all the illusions that arise when he sees everything that he
is not conscious of in himself coming to meet him from outside as projections
upon his neighbor. (Jung, 1983, p. 335)

Jung tells us that any meaningful personal growth requires dealing with this
shadow.

Unfortunately there can be no doubt that man is, on the whole, less good than
he imagines himself or wants to be. Everyone carries a shadow, and the less it
is embodied in the individual’s conscious life, the blacker and denser it is. If
an inferiority is conscious, one always has a chance to correct it. Furthermore,
it is constantly in contact with other interests, so that it is continually subjected
to modifications. But if it is repressed and isolated from consciousness, it never
gets corrected. (Jung, 2014b, p. 131)

In sum, unless an individual is aware of the darkness within, that darkness

will essentially run one’s life. Moreover, the power of the unconscious will
be hidden from the unaware person; they will assume that all their problems
are on the outside when actually these problems are projections of their own
darkness. As Jung says: “Knowing your own darkness is the best method for
dealing with the darknesses of other people” (as cited in Hart, 2007, p. 28).
Jung and the other depth psychologists of course recommend an explora-
tion of the unconscious and then an integration of it into conscious life.

The shadow is a moral problem that challenges the whole ego-personality, for
no one can become conscious of the shadow without considerable moral effort.
To become conscious of it involves recognizing the dark aspects of the person-
ality as present and real. This act is the essential condition for any kind of self-
knowledge. (Jung, 2014a, p. 14)

Breakthroughs of the Abyss—eruptions of the unconscious—occur often.

There is a constant ongoing dialog between the ego and the unconscious. The
more one pays attention, the more one is aware of this dialog. The more one
ignores or represses the unconscious, the more likely that the eruption will be
dramatic and overwhelming or covert and sabotaging.
248 Chapter 11

Conversely, the more one opens dialog with the unconscious, the more it
functions as friend and ally. An individual begins shadow work with the sense
that they need to master a difficult or wounded part of himself. But as one
continues the dialog with the Abyss, a new conception emerges. In the fol-
lowing quote, Jung is not talking about mastering the Shadow, or eliminating
it, or even working with the Shadow; essentially he argues that integrating
the Shadow creates a new sense of the nature of the Self. After repeated dia-
logs with Shadow, the Self begins to live permanently in the space between
the unconscious and the conscious mind. In the language of this book, the
individual lives in the space between the Abyss and the Net—he is “dancing
with the Abyss.” And Jung is not simply recommending that therapists live
in that space. He argues that becoming fully human requires placing the Self
between those two seeming opposites of form and formlessness.

To confront a person with his shadow is to show him his own light. Once one
has experienced a few times what it is like to stand judgingly between the oppo-
sites, one begins to understand what is meant by the self. Anyone who perceives
his shadow and his light simultaneously sees himself from two sides and thus
gets in the middle. (Jung, 1970, p. 872)

Tillich would agree. The ultimate concern always integrates doubt with
faith; it always points toward the Ultimate—and participates in it—but
never fully arrives. Living in the space between dark and light, befriending
both sides without needing to be possessed by one or the other, that is the
ideal state of the depth psychologists. It is also the ideal state of the Reality
B therapist.
This process of identifying the unconscious forces, understanding them,
and attempting to distill their meaning and to work with them is often entitled
“embracing the shadow.” This process is common in therapy and several
vignettes illustrating it have already been offered above. For example, the
eating-disordered teen recovered quickly once she affirmed that the part
that supported the eating disorder was simply an ego state that aspired to
excellence run amuck. And the business man who cheated on his girlfriend
secondary to his dread of ever letting a woman go essentially recovered after
honoring the emotional needs of the child part. In both these examples, a
part which had been vilified and rejected was approached with respect and
appreciation. An exploration was conducted which revealed good intentions
underlying the negative/compulsive behaviors. After validating the good
intentions, the part could be integrated with the whole psyche. As a result, the
negative behaviors/feelings were eliminated.
Virtually all of the dissociative techniques described in the previous chap-
ter can be described as versions of embracing the shadow. Any time a client
 Heart and Soul 249

stands in one part of himself—often a healthy, strong, or adult part—and

reaches out toward a wounded part, or a compulsive part, or a critical part—
some form of embracing the shadow is taking place.
In addition to interpreting symptoms as messages from the unconscious,
depth psychology famously sees dreams as another form of unconscious
communication. The dreams can be worked with in varying ways from
seeing them as a source of insight, or dialoging with them to release emo-
tions or trauma, or even treating them as oracular pronouncements. The
following example of dream work comes from my practice and exemplifies
using dreams as oracles. What makes this example a bit unusual is that the
dream—which was experienced by the husband—was adopted by the couple
as a guide for both of them—a kind of road map for their marital therapy.

A married couple in their late 40s were separated but desired reconciliation.
They were both beauticians; she had a steady and successful practice and his
business was always struggling. Originally from France, they had moved here
20 years ago. They had two grown children who were successfully on their own.
After being married for over 20 years, they had separated a year and a half
ago because of constant fighting. In the past 6 months, he had decided that he
was not only still in love with his wife, but reconciliation was necessary from
a spiritual point of view. He had an extensive background in studying spiritual
texts and teachers. She was somewhat sympathetic to these ideas but distrusted
his tendency to move rapidly from one approach to another especially because
he often declared the latest ideas as “the ultimate.” She also distrusted him
because he was frequently critical of her and the children and was particularly
outspoken whenever she gained a few pounds. Both spouses were attractive
and spoke with appealing French accents. He noted that she worked all the
time—she only took Sundays off—and had made a number of bad investment
decisions which resulted in losing most of their savings. One big investment had
been done behind his back and the other against his advice.
The first session consisted of gathering the background information above
and assessing the level of commitment to reconciliation. He was very enthusi-
astic about reconciliation and argued that they should simply forget the past and
start fresh. Dwelling on the past, he said, was simply being a prisoner to fear and
he wanted her to “quit contracting.” She claimed that she still loved him deeply
in her heart—especially since they had been sweethearts since high school—but
was clear that she didn’t trust him, didn’t want to live with him, and was unwill-
ing to make love with him.
At the beginning of the second session, the husband reported the following
dream.
I am in a nice house and I know that my wife is upstairs in a room. I go up
a stairway to find her and notice that, although it is a very nice stairway, it is
littered with large, abandoned, and broken down items that make the passage
difficult. At the top of the stairs, I find the room. However the door has been
250 Chapter 11

recently blocked by something like masonry and the male worker inside has
reduced the doorway to a small window. He is not friendly and tells me there is
no passage this way but perhaps there is another way.
I pick my way back down the stairs with much effort and go outside to try and
find the other way in. I see that I must cross the neighbor’s property to get to the
back. The neighbor is difficult and bothered by my presence. I request passage
across his property and directions to the back door. I feel nervous about asking
but he grudgingly gives the directions.
I proceed to the back door and enter into a large room. There are a number
of people there including my wife who has taken the form of a brash and shal-
low male that we both knew in our childhood. On a very large TV is a deceased
friend who was the embodiment of loving kindness when he was alive. He is
talking to me and my wife.
Inspired by his loving words, we embrace and I find my wife in my arms, not
the brash young man.
The husband reported that this dream had felt very important to him and that
he had awoken with a positive feeling that somehow all would be well. He had
told the dream to the wife prior to the therapy session and she also had a posi-
tive feeling about it.
We discussed the dream together and arrived at the following interpretation.
The husband, who was enthusiastic about an immediate reconciliation based on
“forgetting the past and having a fresh start,” needed to drop that plan. Instead,
he should recognize that his wife wanted to begin by reviewing key incidences
in the past (stepping carefully down the stairs taking note of the debris) with a
focus on processing interactions with the neighbor and the final reconciliation
would be revealed as we went along. All agreed that the dream was positive and
all agreed to use it as a basic guide in terms of the direction of therapy.
The next few sessions consisted of a review of key conflicts in the past that
embodied his critical side. As we processed the events, he typically started
defensively but was able to take responsibility relatively quickly. The wife
worked hard on her willingness to be direct and assertive, even if it hurt his
feelings. Both reported feeling as if there was progress in resolving the issues.
At the beginning of the next session, the husband said with some frustration,
“we’ve been working hard but I don’t feel like we are any closer. She still seems
disinterested and closed off to me.” As he made the statement, he crossed his
arms across his chest to illustrate her “closed down” feeling. She nodded as he
said this in silent agreement.
I asked whether her “closed off” stance reminded either of any part of the
dream and both identified the attitude of the neighbor. Questioning her on why
she felt so closed off, she quickly said that he continues to act needy in their
interactions—continually questioning her on whether she feels there has been
progress and wanting to know when they will be together. She reported that
she found these “needy” interactions sad and didn’t want to hurt him but she
also experienced them as a “big turnoff.” They dialoged about whether he was
capable of controlling this child part of himself. Initially he said that he couldn’t
 Heart and Soul 251

but when she made it clear that she was unable to be attracted to him as long as
he acted this way, he made a commitment to deal with his child part. He made
an individual appointment with me in this regard, and was able to make some
progress in terms of healing this part.
At the next couple’s session I suggested that he had done the bulk of
changing and perhaps we should look at a part of the dream that offered her
an opportunity to grow. We focused on her incarnation as the brash young
childhood acquaintance. The couple said that this acquaintance was famous
for telling stories that put him in a good light but were exaggerations. He
wasn’t a bad person but was untrustworthy and anything he said couldn’t be
counted on.
The couple agreed that the wife never told such stories but both immediately
focused on the inauthentic quality of the young man. Like him, the wife had
frequently supported decisions that she didn’t agree with and avoided conflict
from fear or self-doubt. Then, in hindsight, she would dislike herself and dislike
her husband for pressuring her into the positions. Both agreed that as long as the
wife avoided making decisions based on her inner truth—instead of fear-based
decisions—the relationship was unlikely to prosper.
Within a week of her vowing to make authentic, inner-wisdom-centered
decisions, the wife underwent a surgical procedure which resulted in some
unpleasant complications that caused her to be in significant pain—and under
the influence of analgesic medication—for about a week. The husband helped
nurse her and was very supportive. About half way through her recovery, he
asked her if he could move in—just for a few months cause he had no place to
go—and she agreed. At the same time, she got very busy at work and did not
come into therapy for almost 2 months.
When they resumed, their condo was in escrow and they needed to move
within 3 weeks. The wife was adamant that she did not want to live with the
husband and he began to alternately threaten and beseech her to change her
mind. First he said that if she didn’t find a place with him, the marriage was
over immediately. Ten minutes later he offered to have patience if she would
just let him live with her for 90 days in order to make her love him. The wife
was firm about not living with him and told him that his combination of threats
and begging was not only confusing, it was unattractive.
I pointed out that allowing him to live with her when she was recovering from
the operation was exactly the kind of behavior the dream had cautioned against;
she had abandoned her authentic feelings and given in to his neediness and
begging. Moreover, letting him in under those circumstances would preclude
making any progress in terms of their intimacy. Upon reflection, she agreed
and stated that she had experienced a peculiar feeling over the past two months
of living together where she felt self-conscious about allowing him to see her
partially disrobed and completely adverse to him seeing her naked although they
had been married many years. Essentially she endorsed the concept that allow-
ing him into her house out of fear and manipulation doomed the possibility of
becoming closer over the two months.
252 Chapter 11

At this point, the husband began to panic at the idea that the wife might be
able to stand up to him. He gave her an ultimatum, “Let me live with you or I
will terminate the relationship.” She held strong and they separated once and
for all.

While a number of techniques were employed in the vignette, it was included

to illustrate the oracular nature of the Abyss/Unconscious Mind. All three of
us treated the dream like a symbolic instruction manual that, if followed cor-
rectly, offered a plan for reconciliation and enhanced intimacy. Their refusal
to follow it during the surgery phase slowed the process down enormously.
And, while they were busy during those two months selling their condo, both
agreed that dropping out of therapy at that exact moment was primarily due
to their knowledge that—because of the roadmap inherent in the dream—I
was unlikely to endorse their plan of living together. The wife regrouped and
began to follow the implicit instructions of the dream. The husband, con-
versely, in choosing to disregard the dream instructions, moved in a direction
that led to terminating the relationship.
This case can be framed as a failure of marital therapy, an empowerment
experience for the wife, or a tragedy for the husband. Each is true from its
own perspective. A more interesting question, however, is the accuracy/help-
fulness of the dream material.
Constructionism sees waking and conscious life is a construction; there-
fore, it is consistent to argue that dream material—and especially dream
interpretations—are even more constructed. But dream material, because it
comes from the unconscious, always has a numinous quality that suggests
some kind of validity beyond mere constructionism. In spite of this numinos-
ity, it seems absurd to argue that dreams are true and accurate instructions
from the unconscious. The fact that different therapists interpret the same
dream differently destroys that thesis.
The Jerome Frank model offers a solution to this dilemma. Rituals that are
invested with belief by therapist and client are both more powerful and more
effective. The numinosity of dreams suggests the presence of a kind of exis-
tential validity—a validity which often seems to infuse the resulting ritual. In
this sense, anything that encourages client and therapist to revere the power
of dreams and the accuracy of the interpretation will make the dream work
more effective.
Even more important, however, is that with soul making, shadow work,
and heart connection, the numinosity points beyond itself. Apollonian work
celebrates the primacy of the conscious mind and the worth and the impor-
tance of the individual. The work in this chapter moves past the individual
and endorses a feeling of powers beyond self. To put it another way, depth
psychology and shadow work offer the opportunity to relate to the oracular
 Heart and Soul 253

side of the Abyss; there is a sense of connection to something existential and,

perhaps, something spiritual.
In sum, affect in constructed space can be understood from a variety of
perspectives. Apollonian therapies see affect as essentially dangerous and
attempt to subordinate it to conscious control and the ego. Affect is close to
the Abyss; it is dark, unconscious, and threatening. Apollonian forces neces-
sarily take vows to resist affect, correctly sensing that it is implicitly commit-
ted to undermining order and predictability.
Reality B psychologists, however, are committed to working with Diony-
sian forces without subordinating them to the ego. Moreover, they understand
that charisma ultimately flows from the Abyss. In pursuit of the accumulation
of charisma, it is necessary to experience the affective nature of constructed
reality in itself without attempting to reduce it to irrational thoughts, trauma,
and mislearnings. And, of course, the best way to master a field of study is to
choose to teach it to another.

THE ABYSS AS ORACLE

The “kingdom of God” is not something one waits for; it has no

yesterday or tomorrow, it does not come “in a thousand years”—it is
an experience within a heart; it is everywhere, it is nowhere.
—Friedrich Nietzsche, The Antichrist (1895)

The Abyss is typically seen as terrifying and destructive. Yet in the last
section, the depth psychologists argued that when the Abyss is approached
appropriately, it can be a force for empowerment, understanding, and mean-
ing. In this sense, a breakthrough of the Abyss can have an oracular quality.
That said, the Abyss is never to be touched lightly given that its most
prominent qualities are anomia and disintegration. Paradoxically, that is what
is potentially most attractive about it. The Net is so solid and substantial, that
the only way to “wake up” is to be shaken out of sleep, often violently and
painfully.
In that sense, the Abyss has always had a special place in mysticism and
spiritual life; it is feared and respected—seen as the great threat and the
great blessing simultaneously. Martin Buber has written about this genera-
tive aspect of the Abyss. In the quote below Buber shows his reverence for
the Abyss and particularly emphasizes the part it plays in moving from the
secular to the spiritual.

Buber underlined the fact that the collapse of the secure and harmonious world
of childhood would come sooner or later to every person and the abyss at his
254 Chapter 11

feet would suddenly become visible. “All religious reality,” . . . Buber was to
state many years later, “comes when our existence between birth and death
becomes incomprehensible and uncanny, when all security is shattered through
the mystery.” (Friedman, 1988, p. 155)

Moreover, Buber calls us to voluntarily cast ourselves into the Abyss.

(Y)our motto will be: God and danger. For danger is the door of deep reality,
and reality is the highest price of life and God’s eternal birth. . . . All creation
stands on the edge of being; all creation is risk. . . . You must descend ever anew
into the transforming abyss, risk your soul ever anew, ever anew dedicated to
the holy insecurity. (Buber, 1964, pp. 98–99)

In these two quotes Buber discusses the evolution in consciousness from the
“secure world of childhood” to the experience of the Abyss. He lauds “holy
insecurity.” Buber is urging man to move beyond “joining the tribe” and ful-
filling simple human needs. At some point, in order to proceed further along
the Tillichian path, an immersion in the Abyss becomes necessary.
Buber suggests that after one becomes a fully enfranchised member of the
culture, the next task is the “collapse of the secure and harmonious world.”
Premature collapse into the Abyss only generates terror and decompensation.
Staying too long in the culturally sanctioned world invites idolatry. Joining
a culture in the wrong way can lead to a violation of the soul. In Tillich’s
words, the healthiest ultimate concern can become idolatrous if pursued in
the wrong way or at the wrong time.
Hillman, Jung, and other depth psychologists believe that the break-
throughs of the Abyss, in the form of pathologizing, dreams, or terrifying
epiphanies, serve as maps and “marching orders.” Of course, they would
agree, the oracular instructions in the experiences are symbolic and often
hidden—they need interpretation and working through—but at the end of the
day, they are messages that show the way. Campbell agrees and also notes
the secret qualities of the Abyss.

The separateness apparent in the world is secondary. Beyond that world of

opposites is an unseen, but experienced, unity and identity in us all. (Osbon,
1995, p. 25)

The perennial philosophy has been mentioned previously; advocates of this

approach argue that philosophers and seekers from all cultures across all
time periods come up with common principles for living deeply and thought-
fully. One of the common terms in the perennial philosophy is the concept
of the “secret knowledge.” The most common form of the secret knowledge
is constructionism itself—the concept that all we hold dear and believe in so
 Heart and Soul 255

passionately is essentially “made up.” A second form of secret knowledge is

what Campbell has just referred to: the hidden connections that unite us all.
A final form is the one emphasized in this chapter: the Abyss is outwardly
horrible but inwardly oracular and healing. The meaninglessness is paradoxi-
cally the source of meaning.
This chapter asks the therapist to shift from an affiliation with the Net to a
stance which is much closer to the Abyss. The clarity, simplicity, and mastery
of the Net recedes to be replaced by feelings that lead without clear direction,
shadow work that may be soulful but rarely results in complete resolution,
and a pervasive mystery that refuses to be dispelled. This is, indeed, a dif-
ferent place in constructed reality—a location older, more fecund.Those who
can make such a place their home must evolve from the relative daylight of
the Net.
Some therapists have problems with shadow work and emotions; just as
many may be challenged by assuming the mantle of power implicit in the
Apollonian therapies. Enhancing charisma requires a commitment to move
forward regardless of the comfort level. Lest this seem too heavy, Walt
Whitman has some reassuring words. “Keep your face always toward the
sunshine—and shadows will fall behind you.”
 Chapter 12

The Other Royal Road

Social Determinants of Change

Dreams are the royal road to the Unconscious.

—Sigmund Freud, The Dream Problem (1916)

No therapist can explore the geography of constructed reality without explor-

ing one of the strongest forces that sustains it: social validation. Understand-
ably, this book has concentrated on the power of charismatic individual to
change the structure of reality. This chapter puts that focus aside and exam-
ines how to work with the social forces that sustain the Net and the individual.
Constructed reality is dependent on social concurrence. In that sense, real-
ity is structured, supported, and changed by the client’s interactions with his
primary social group. To belong to a group is to adopt its values and world-
view. This can be a force for evolution or devolution, of course, but when
it is positive, it results in a kind of graceful and relatively effortless change.
In this sense, the “royal road” of change is through understanding and
working with the social aspect of clients. Therapists understandably focus
on the kind of right brain-to-right brain connections that occur in individual
therapy, but it is just as heart-connected to focus on the interconnections
between the client and his social groups.
This is particularly true because the “I” that exists when I interact with
one group is often quite different than the “I” that is present with a different
group. The chapter on identity offered many examples of how easily a person
can shift personas with the correct cues and there are no cues more important
than social cues. The question of whether the “I” at work is truly different
than the “I” at home has already been explored; what is more important is that
constructionism allows us—nay, requires us—to work effectively with all the
implicit possibilities. More specifically, being heart connected as a therapist

257
258 Chapter 12

requires us to feel all of the connections between the client and others and
have a willingness to creatively intervene when appropriate.
The chapter on identity examined how the Self manifested at different
places in constructed reality. The unitary self was championed by the Apol-
lonians; Dionysians prefer multiple selves both to release shame and guilt
and to enhance the possible. Eastern spirituality tells us that there is another
form of self—no self or universal self—that fits the more Abyss-centered
aspects of constructed reality. In the same way, therapists are enjoined to
work with the social forces that surround the client. One can use structured
groups and social roles to meet Apollonian goals, process groups and high
impact retreats to meet Dionysian goals, and Sanghas to work with spiritual
ends. Social endorsement is the glue that holds everything together. Working
effectively and consciously with social determinants is a primary goal of the
constructionist therapist.
And we will typically be delighted at the possibilities that open up when
we do. I recall an example from my own practice that will probably sound
familiar to most therapists.

Some years back a young man in his mid 20’s was referred to me by his parents.
It seems that this young man had done well in high school and received adequate
to good grades and had many friends, but at present he was disinterested in
going to college. Instead, he had found a job in construction. He continued to
live at home, worked diligently at his job, and partied hard every weekend. The
parents were worried about his lack of interest in adult goals and so had referred
him to me to work on his values and maturity.
The young man was a pleasant person and, even though he was being
“forced” into therapy, had resolved to make the best of it; after 3 or 4 sessions
we were making steady, albeit modest, progress towards clarifying his attitude
towards “growing up.”
Now this young man had a best friend, who worked with him at his construc-
tion job and who partied with him every weekend. He was more-or-less a carbon
copy of the person I was working with. Around the fifth session with my client
he came in with some news. It seemed that the friend had accidentally gotten his
girlfriend pregnant. After some reflection, he had decided to marry her. He had
approached his parents about helping him go back to school because, of course,
now that he was about to be a father, he needed to step up and be a responsible
provider.

Of course this was more of a change due to accepting a new social role versus
direct influence from a group. But role acceptance is a form of group influ-
ence; the role is defined by group expectations and in stepping up to “being
a father,” the friend was doing what was necessary to maintain the respect of
his social group.
 The Other Royal Road 259

Without any attempt to set up an experiment, I had been presented with

evidence bearing on the relative power of changes secondary to role accep-
tance versus changes due to therapy. Certainly no psychotherapist would be
surprised at my story; what is important, however, are the implications of it.
Stepping up to a role change transformed the friend profoundly in a week’s
time. I was going to need ten or twenty weeks of therapy to achieve the same
result and, even then, I suspected that my psychotherapy result would not be
as solid as the changes engendered by role acceptance.
These kinds of changes are familiar to every therapist. For example, a
high school student who goes off to college is often exposed to a different
peer group with different worldviews. Typically such exposure results in
inculcating new values, choices, and behaviors in a fairly effortless man-
ner. These changes often involve beliefs that are radically different than the
values implicit in one’s family of origin. The new beliefs result in different
behaviors and in choosing different experiences and often culminate in the
individual living a completely different life than they might have experienced
if they had stayed in the original home town. These changes happen fairly
rapidly and often last for the rest of the individual’s life.
Similar changes can occur if a person picks a certain profession or moves
to a certain city. For example, getting a position in a major Wall Street firm
on graduation from college is likely to result in far different worldview altera-
tions than taking a position at a home town bank. Working as an international
journalist will create a radically different personality than selling insurance
in Topeka. And virtually everyone has a story about a person who “found
religion” and almost overnight adopted changes that were permanent or at
least lasted for many years.
Like the example above, adopting certain roles in life typically generates
profound changes. We say, “becoming a father made him grow up” referring
to adopting a new worldview associated with maturity, other-centeredness,
and stability. Similarly, a leadership role at work or at church can create
significant changes in confidence, risk taking, and social functioning without
much effort whereas a similar demand by one’s psychologist might be met
by resistance and slow growth. Finally, possibilities of reward—whether it
be monetary reward, a desirable marital or social position, or fame/recogni-
tion—will often result in meaningful changes that are accomplished rapidly
and with little resistance. Significant “carrots or sticks” often create changes
in values, behaviors, choices, and maturity much more effectively and effort-
lessly than psychotherapy.
Such examples not only affirm the power of the social group, they also
speak to the ease of change and the essential fluidity of constructed real-
ity. As was discussed above, the Reality B therapist is marked by his belief
that change is easier than commonly thought. Conversely, the Apollonian
260 Chapter 12

therapist argues that change is difficult or slow. The relative ease of change
seen in via the influence of a new peer group—particularly when it is associ-
ated with significant rewards or punishments—completely supports the con-
cept of fluidity and ease of change.
Therapists typically create or contribute to social change in a straight-
forward manner—that is, they directly recommend that the client become
affiliated with a new group or they urge that the client adopt the new and
more constructive set of values. In contrast to that kind of directness, there is
a well-known story of Milton Erickson making such a suggestion but in his
own, characteristically indirect, fashion.
Erickson was asked to visit the aunt of one of his colleagues because he
was concerned that she was seriously depressed. The aunt was wealthy, and
lived in an old family mansion; she was in her 60s and medical problems had
put her in a wheelchair. Unmarried and without any close relatives, she was
socially isolated and had had some suicidal ideation.
The aunt met Erickson at the front door and gave him a tour of her dark
and old-fashioned house. At the end of the house tour, she showed Erickson
her greenhouse.

The aunt saved the very best for last, however, and finally ushered Erickson into
the greenhouse nursery attached to the house. This was her pride and joy; she
had a green thumb and spent many happy hours working with the plants. She
proudly showed him her latest project—taking cuttings from her African violets
and starting new plants.
In the discussion that followed, Erickson found out that the woman was very
isolated. She had previously been quite active in her local church, but since her
confinement to a wheelchair she attended church only on Sundays. Because
there was no wheelchair access to the church, she hired her handyman to give
her a ride to church and lift her into the building after services had started, so
she wouldn’t disrupt the flow of foot traffic into the church. She also left before
services had ended, again so she wouldn’t block traffic.
After hearing her story, Erickson told her that her nephew was worried about
how depressed she had become. She admitted that it had become quite serious.
But Erickson told her that he thought depression was not really the problem.
It was clear to him that her problem was that she was not being a very good
Christian. She was taken aback by this and began to bristle, until he explained.
“Here you are with all this money, time on your hands, and a green thumb.
And it’s all going to waste. What I recommend is that you get a copy of your
church membership list and then look in the latest church bulletin. You’ll find
announcements of births, illnesses, graduations, engagements, and marriages in
there—all the happy and sad events in the life of people in the congregation.
Make a number of African violet cuttings and get them well established. Then
repot them in gift pots and have your handyman drive you to the homes of
people who are affected by these happy or sad events. Bring them a plant and
 The Other Royal Road 261

your congratulations or condolences and comfort, whichever is appropriate to

the situation.” Hearing this, the woman agreed that perhaps she had fallen down
in her Christian duty and agreed to do more.
Twenty years later, as I was sitting in Erickson’s office, he pulled out one
of his scrap-books and showed me an article from the Milwaukee Journal
(or whatever the local paper was called). It was a feature article with a large
headline that read “African Violet Queen of Milwaukee Dies, Mourned by
Thousands.” The article detailed the life of this incredibly caring woman who
had become famous for her trademark flowers and her charitable work with
people in the community for the ten years preceding her death. (O’Hanlon,
2000, pp. 6–8)

If Erickson had been more direct, he would have suggested she become
an important person in the church—perhaps some sort of a “designated
greeter”—but it is likely that this idea would have been rejected by the
depressed woman as “too demanding.” He worked around this potential
resistance with his characteristic elegance and grace; his skillfulness is
the usual reason that this example is cited. But for our purposes, he sim-
ply connected her to a group in a way that ensured that she would be in a
powerful and meaningful role that had the potential to be self-sustaining.
Erickson’s skill and charisma got her going but it was the power of the
healthy group and the meaningful role that proved healing and transforma-
tive in the end.
The important point is not how the client is motivated to connect to the
healing group experience; rather, one should think hard about how power-
ful these kinds of experiences are in comparison to the traditional hour of
therapy. In most cases, these interventions are much more powerful and
long lasting than the effects of therapy. That being true, it is probably worth
investing a significant amount of time in the room planning and carrying out
such referrals.
Most of these kinds of referrals result in Apollonian changes: evolutions
in social roles, connections to more motivated and high status people, and
exposure to values that allow the client more mobility, fluidity, and hardi-
ness. While this is true, it is also possible to refer to groups that explicitly
cultivate Dionysian experiences and growth. In the case below, I worked
with a young person whose world was so dominated by ideas of “should and
ought” that he hardly had room to breathe.

Mark was a 20-year-old Caucasian male was referred to me by his mother for
treatment of depression. It seems that the young man had gotten lost in high
school and had a poor experience characterized by no significant friends, no
girlfriends, lots of video games, and lots of marijuana. He eventually dropped
out of high school and started abusing his Adderall and later graduated to full
262 Chapter 12

scale methamphetamine use. In the eight months before I saw him, Mark had
become sober, was attending AA, and had gotten a GED. He still hated school,
was socially isolated, and felt he had no sense of direction. He was working
in a restaurant but barely made enough to pay his bills and was living with his
mother.
At the initial session he presented with a “heavy” demeanor—characterized
by lots of “shoulds and oughts”—mixed with a sense of fatigue and purpose-
less. He told me that he was very committed to his sobriety but hated his current
work in the food industry and thought that going to school more than part-time
would be unthinkable due to his residual dislike of education from high school.
He had no plan beyond a vague—“I want to make a lot of money”—and was
essentially doing nothing beyond working and video games. He was modestly
interested in getting a girlfriend but he had no idea of how to find one and was
disinterested in the girls at his job. Finally Mark had no friends and did nothing
for fun.
I suggested that he had a “fun deficit” and told him that he would benefit from
a summer working in Yosemite Valley. He quickly researched the available jobs
and was hired within 3 weeks and started 3 weeks after that. Our four sessions
before he left were focused on discussing how to get the most out of his summer
job and what kinds of fears needed to be dealt with to maximize his experience.
He worked in Yosemite Valley from May through September and came back
into therapy upon his return. He reported that his social life had been intense
and rewarding; when he wasn’t out having adventures, he had a nonstop stream
of friends coming by his tent cabin. He had a summer girlfriend and it was clear
to him that he could have had several others if he had wished. Finally, he went
on a series of adventures—from climbing 5.10 rock, to belaying from a hanging
belay, to leaping into hidden pools and waterfalls, to participating in a secret
“pendulum swing” off of a bolt on El Capitan. In sum, he had a summer which
validated him as a friend, a lover, and a bold adventurer.
Upon his return, all talk about his inability to do well with friends and girls
was gone; he had just proved that he was good at those activities in a way that
even he could not dispute. Just as importantly, he had a glint in his eye and saw
life more as “what’s my next exciting experience?” instead of “how do I get
through the next boring day as a ‘good boy’”?

In many ways, this experience was Apollonian in that Mark used the Yosem-
ite experience to make up for his lost high school experiences with friends
and relationships; in short, he succeeded at accomplishing developmentally
appropriate milestones which had been neglected. But it was special in that
he accomplished the neglected milestones with a bang and far overshot the
mark of “adequate achievement.”
But the intervention had a Dionysian component as well. Mark returned
from the summer believing that Yosemite Valley, and the people who live
and work there, are special. The next chapter discusses the concept of “sacred
 The Other Royal Road 263

space” and Mark certainly believed that he had come back from a “pilgrim-
age” to sacred space. Moreover, as a denizen of sacred space, he had a subtle,
archetypal identity shift and no longer believed he was a normal or subnor-
mal person. He felt touched by the mystical and transformed in ways that
he didn’t really try to elaborate. He simply summarized his experience with,
“You needed to be there to really understand.”
This encounter with the mystical left an unpredictable stamp upon Mark
that was entirely Dionysian. He wasn’t sure upon his return what he would
do next but, somehow, he knew that it was going to be meaningful and going
to contribute to the development of his life. He had walked out of the “wil-
derness” with an inner sense of knowing the location of his personal “north.”
Some of this came from Yosemite, some came from how all his new friends
framed their time in Yosemite, some of it came from saying yes to experi-
ences on rocks, beside waterfalls, and with his girlfriend. Wherever it came
from, Mark somehow felt initiated into a new order of being. And this sense
of being embodied a Dionysian shift.
Examining all three of the examples—the young man who got his girlfriend
pregnant, Erickson’s violet woman, and the Yosemite worker—the first thing
that is clear is the remarkable power of such interventions, at least when they
are done thoughtfully. Literally Erickson spent an hour or so with a woman
in her home, but his intervention transformed her for the remainder of her
life. The Yosemite intervention took a bit more than an hour and resulted in
a new sense of self plus a fresh dialog with the meaning and overall direction
of his life. And the pregnant girlfriend story happened without a psychologi-
cal intervention but significantly overshadows typical therapeutic efficacy.
All three of the stories are straightforward and clear. Even the Erickson
intervention, which is often touted as a brilliant example of indirect sugges-
tion without trance, is—at the end—a simple referral. Most therapists are
completely capable of planning and making such referrals. But, of course,
prioritizing such referrals is not common. However, when one equates the
power of such referrals with the power of the therapeutic wizards, then there
is sufficient motivation to consider them as a primary level intervention.
Narrative therapy (Madigan, 2012) has advanced an idea that the Self
exists between the individual and her social world (instead of within the indi-
vidual). This implies that there is a new Self with every meaningful altera-
tion in the social world. Using simple logic, this suggests that the client who
presents with a mental health diagnosis in my office and in her current social
world might not even have a diagnosis in a different social world. It is easy
to argue that Mark was depressed when he walked into my office and that his
successful social life in Yosemite helped alleviate his depression. It is prob-
ably more accurate from a constructionist point of view to say that the self
264 Chapter 12

that was generated via dialog between Mark and the Yosemite world never
had depression; indeed, that self was incompatible with depression.
The depressed self was the result of Mark’s dialog with his standard world.
In that world, he was a recovering meth addict who needed to be serious
about his recovery, being a responsible young man, and performing the hard
work required to get friends and a relationship. The dialog with the Yosemite
world created a self who was sociable, sexy, and up for any kind of healthy
adventure. Did he gradually recover from his depression and the new quali-
ties evolve slowly? Certainly the Apollonians, with their emphasis on ego sta-
bility, would so argue. But in reality he told me that he felt different from the
moment he drove into Yosemite Valley. Did the referral allow a completely
different self room to emerge? In that case, it was more than a referral; it was
a profound psychological intervention. Conceptualizing social interventions
in such a manner enhances therapist motivation and sensitizes them to the
actual power that lies in the social approach.

APOLLONIAN GROUP THERAPY

The three great essentials to achieve anything worthwhile are, first,

hard work; second, stick-to-itiveness; third, common sense.
—Thomas Edison, Men who are Making America (1917)

Psychology seems to have created a group protocol to address almost every

human ill. There are groups for assertiveness, weight loss, personal growth,
parenting, anger management, divorce, cancer support and on and on. The
good news is that virtually every group that is created to address a specific
problem works. Recall the earlier chapter where it was argued that “every-
thing works.” When a group sets a goal of achieving any reasonable psycho-
logical change, they will succeed at it. The specific curriculum matters little.
If the group members are united in their purpose, and the group leader suc-
ceeds at creating a positive milieu with healthy expectations, then the group
will achieve the modest, positive outcome that psychotherapy—individual or
group—reliably generates.
The efficacy of this type of group therapy rests on three main concepts:
1) support and guidance from the group, 2) support and guidance from the
leader, and 3) skills training. Since the research has consistently shown that
skills training is not the active ingredient in therapeutic change, that leaves
the effects of the leader and the effects of the group on the client.
The leader’s function in these groups is somewhat limited. First of all,
many of these types of groups are “manualized”—that is, they have a set
 The Other Royal Road 265

curriculum that tends to restrict spontaneous discourse and which takes up

the majority of the group time. Moreover, a number of these sorts of groups
are leaderless support groups—for example, AA meetings and certain divorce
recovery groups—and consist of clients listening to each other and sharing
their own stories without significant “cross-talk.” In sum, in these types of
groups, the social or subcultural aspect is likely to be the most important fac-
tor contributing to therapeutic efficacy.
Of course, the previous section demonstrated that the influences of a
subgroup are, indeed, quite powerful. As Berger and Luckmann point out,
humans are social animals with a strong urge to conform to their current
group in terms of adopting group norms to gain approval and full member-
ship. Given that all of these groups require healthy or healthier behavior to
attain full membership, it is not surprising that clients who attend parent skill
training groups become better parents and clients who attend divorce recov-
ery groups move on from their divorces at an accelerated rate.
Moreover, even when the leader does not supply a preexisting curriculum,
selected lead figures in the group will supply it for him. If it is an anger man-
agement group, the leader can count on certain members telling stories from
their own lives which illustrate some of the best techniques to control anger.
But the secret, of course, is not the curriculum; it is the enhanced motivation.
Knowing that I am going to return to my relapse prevention group next week
and share my relapse-related experiences with them motivates me to control
my impulsivity and make better choices. Before my group membership I had
certain forces in my life moving me toward relapse and other forces moving
me toward sobriety. Now I have those same forces with the addition of pleas-
ing the group.
The power of the group changes depending on how important affiliation
with the group is to each client. Some find group membership enormously
rewarding and their motivation increases proportionally; others not so much.
In this sense, group leaders need to pay more attention to affiliation and car-
ing than to curriculum and skills building.
Almost all of the groups that are centered on problems and trauma recov-
ery are fundamentally Apollonian. In essence, their focus is on rejoining
the culture (e.g., divorce recovery and relapse prevention), executing social
roles more effectively (e.g., assertiveness groups and parenting groups), or
symptom control (e.g., pain management). Some groups focus on helping
those who have never had a role in the culture (e.g., life skills groups and
DBT groups). Whatever the specifics, all of these groups have Apollonian
goals and are executed in an Apollonian style. They are not intended to be
transformative as much as facilitative.
That said, such groups are successful, do a great deal of good, and are
generally praised by both the clients and the leaders who run the groups.
266 Chapter 12

Research, unsurprisingly, finds that these sorts of groups achieve the modest,
positive outcomes universally found in psychotherapy. The primary negative
critique of this kind of group therapy comes from Gergen with his point about
the pathologizing of the human condition. Gergen reminds us that conditions
and syndromes are constructed and are “discovered” at a rate directly pro-
portional to the number of professionals involved in mental health. Narrative
therapy adds a related argument when they state that the explicit or implicit
labeling incumbent in being a member of these sorts of groups moves the
“authoring” of a client’s narrative out of her hands into the hands of mental
health professionals.
In sum, many of the groups developed by professional psychology are
Apollonian in style and substance. They do succeed at helping many clients
join or rejoin the culture, enhance their social roles, and become more suc-
cessful. At the same time, there is some danger that the implicit pathologizing
of some of these approaches may be a net negative for certain clients.

DIONYSIAN GROUP THERAPY

The Stars are setting and the Caravan Starts for the Dawn of
Nothing—Oh, make haste!
—Omar Khayyám, Rubáiyát of Omar Khayyám:
The Astronomer-poet of Persia (1859)

A good therapist displays above-average charisma, but a great therapist—a

therapeutic wizard—has charisma plus the ability to generate and work with
altered states. Dionysian change is discontinuous and outside the net, a pop
that is dependent on a significant disconnection from the normal reality. In
this same sense, Dionysian group therapy uses the same power of social
endorsement seen in the role evolution and Apollonian group therapy already
discussed. But it adds the power of altered states.
Achieving an altered state in a group therapy context is almost ridiculously
easy. Many, many writers, chief among them Irvin Yalom, have argued the
presenting the intimate issues of one’s life in a group context essentially cre-
ates an altered state. There are many variations on how this altered state can
be created—psychodrama, encounter groups, and so on—but Yalom recom-
mends what he call the “process group.”
Yalom describes the process group as a group which has a here-and-now
focus and an emphasis on process not content. This kind of unstructured
environment invites clients to manifest their characteristic external behaviors
and challenges in real time in the group. This often results in group members
 The Other Royal Road 267

having strong feelings about certain other members who “push their buttons”
and creates an accessible environment to work on the issues.
Importantly, this same recipe virtually guarantees regular altered states in
the group members. Yalom points out that there is a taboo on sharing intimate
feelings and experiences in public; the group requirement to do so elicits
altered states in both the person sharing and in the listeners.
Yalom is unwilling to assume that simple sharing of intimate details is
sufficient to create the altered states he desires. In addition, he prescribes a
set of techniques which tend to enhance the probability of creating altered
states. Most of these techniques encourage the client to be more vulnerable
by sharing her perception of the characteristics of other group members or
the group process itself.

If a member comments that the group is too polite and too tactful, the therapist
may ask, “Who are the leaders of the peace-and-tact movement in the group?”
If a member is terrified of revealing himself and fears humiliation, the therapist
may bring it into the here-and-now by asking him to identify those in the group
he imagines might be most likely to ridicule him. Don’t be satisfied by answers
of “the whole group.” Press the member further. Often it helps to rephrase the
question in a gentler manner, for example, “Who in the group is least likely to
ridicule you?” (Yalom & Leszcz, 2008, p. 158)

Yalom is a veteran of the 1960s and, as such, has experienced all of the wild
escapades that characterized experiential group therapy from Esalen, to nude
encounter groups, to emotional release groups. As a result of these experi-
ences, he is quick to point out that an altered state alone is insufficient to
create change.

The mistaken assumption that a strong emotional experience is in itself a suf-

ficient force for change is seductive as well as venerable. Modern psychotherapy
was conceived in that very error: the first description of dynamic psychotherapy
(Freud and Breuer’s 1895 Studies on Hysteria) described a method of cathartic
treatment based on the conviction that hysteria is caused by a traumatic event to
which the individual has never fully responded emotionally. Since illness was
supposed to be caused by strangulated affect, treatment was directed toward
giving a voice to the stillborn emotion. It was not long before Freud recognized
the error: emotional expression, though necessary, is not a sufficient condition
for change. (Yalom & Leszcz, 2008, pp. 30–31)

Yalom believes that these altered states must be paired with what he calls
“illumination” to actually create change. By “illumination” Yalom means that
the nature of the group member’s problem or challenge must be defined in
such a manner that both the individual and the other group members achieve
268 Chapter 12

consensus about its nature and characteristics. Simple examples would

include concepts such as “she is a people pleaser.” Both the individual and
the other group members will have seen examples in real time in the group
and heard about examples of these behaviors in real life. Once the problem is
illuminated—that is, defined and accepted—the group creates an experience
or experiences which serve to resolve the issue. For example, the individual
could stand up to another group member or share a similar experience from
real life. This illumination process plus the “resolution activity”—usually
carried out in an altered state—results in meaningful change.
If Yalom’s prescriptions seem structurally identical to Jerome Frank’s
common factors theory, the resemblance is hardly accidental. Frank tells us
that change begins by generating and accepting a theory that accounts for the
origin of the problem and then concludes by passage through a ritual that is
seen as capable of resolving the problem. In Yalom’s process groups, illumi-
nation refers to group consensus about the origin theory; the ritual of resolu-
tion is implicit in the group process. Put another way, after the group achieves
agreement on the core issue and its explanation, the ritual typically consists
of performing behaviors either in the group or witnessed by the group which
symbolize healing and resolving the core issue. The person with an “anger
issue” shows control; the person who is alienated and socially withdrawn
reaches out to others.
And, of course, because the group almost inevitably includes altered states,
the ritual becomes Dionysian; that is, the ritual occurs “outside the Net” and
it can be assumed that the client can make a rapid and meaningful change
without needing to follow rules about gradual and incremental growth. A
simple example from my own practice illustrates the point.

Georgia was an attractive and intelligent woman in her early 40s who worked as
a title officer. She was divorced and had one daughter. A devoted mother and a
diligent professional, she spent many hours working overtime and making sure
that every task was done perfectly.
She joined group because she had a boyfriend who cheated on her chronically
with a variety of other women. After briefly being furious at him, she would take
him back and continue in the relationship until the next infidelity, which typi-
cally occurred every two or three months. The relationship had lasted for over
three years and, interestingly, she tended to be somewhat amnesiac about how
many infidelities and the details of each one as if she had been using some kind
of primitive denial or repression to minimize her pain.
When she entered group, she reported that she had had a difficult childhood
with a mother with mental health problems and a stepmother who would not
allow her to live with her father. She said that she was rarely depressed but she
was bothered by the fact that she couldn’t leave her boyfriend in spite of his
repeated misbehaviors.
 The Other Royal Road 269

As one might expect, the group reacted to this presentation with a mixture
of supportive comments extolling her core self-worth and an equal number of
confrontive comments about not being a door mat to the boyfriend. A number
of months went by and, while Georgia reported enhanced self-esteem and more
insight into the situation, she was unable to leave the boyfriend. Particularly
after the group had heard several new examples of infidelity, the confrontations
became stronger, but Georgia was unable to hold her boundaries and always
took him back.
I had had a number of individual sessions with her before I referred her
to group and was aware that the details of her childhood, especially with her
mother, were truly horrific. One day in group, while she was talking to another
woman about her relationship, Georgia commented that, “I always have a dream
that someday some man is going to look at me from across the room and feel
‘that woman would make me truly happy. I choose her.’” I commented, “but
something always comes up and says ‘no one could ever really see me that
way. . . .’ Georgia, why don’t you tell the group more details about what hap-
pened in your childhood and why you can never be special?”
Georgia took a deep breath and began to describe a childhood characterized
by her mother’s severe mental health problems including beatings, neglect, liv-
ing in filth, being locked in closets, and being shunned by her peers and their
families. When her mother was finally remanded to a long term mental health
hospitalization, her father’s new wife wanted nothing to do with her and actively
worked to kick her out of the family. As the group listened to the horrific details,
one member began to cry. At the conclusion, there was silence before group
members began to make supportive and empathic statements.
After the support, the Georgia shared that she always believed she would
be judged and rejected if anyone knew the details of her upbringing. Different
group members connected this to the sense that no man could ever see her as
special.
The following week, the group checked back in with Georgia. I suggested
they begin by each member sharing how Georgia’s story had impacted them
over the subsequent week. Each member talked about how deeply they had
been moved by the awful details of her abuse, how they admired her strength
in terms of creating a functional life post-abuse, and how they respected the
courage it had taken to share the history. Georgia felt validated and supported
by these recitations.
Within three weeks Georgia broke up with her boyfriend and a month later
she began a relationship with a new man. She stated that she believed that the
new relationship was the first healthy relationship she had ever had in her life.

While this vignette is an example of solid therapy, it is far from remarkable.

Similar experiences occur on a daily basis in various forms of group therapy
ranging from AA, to survivor groups, to process groups. However, while the
therapy isn’t that unusual, it clearly illustrates illumination, ritual, and altered
states.
270 Chapter 12

This simple example brings back the questions about whether rituals are
real or constructed and invented. This ritual was based on the modern cul-
tural assumption: “you’re only as sick as your secrets.” This expresses the
straightforward idea that when humans carry an emotional burden on their
own, especially when it is linked to guilt and shame, the act of carrying and
hiding creates an inner sense of heaviness, sadness, and self-deprecation.
Conversely, when this burden is shared, and when that sharing results in
acceptance, then the person is set free and has more capacity for growth and
vitality.
It is important to understand, however, that this intervention is a ritual
masquerading as a technique. It is only “real” because a particular subculture
of Western culture believes it to be real. This idea would be a hard sell in
sixteenth-century Japan, for example. But for our subculture—Westerners
who believe in psychotherapy—it feels like a “truth.” Hence, when a client
undergoes a ritual that embodies the “secrets” principle, they will be changed
and the witnesses will find their change credible. It’s a perfect example of
creating a shared reality.
Most importantly, groups provide a “mini subculture” that supports the
client’s new identity. Dionysian change, rapid change, usually runs into the
challenge of sustainability. Following the change, as the client attempts to
reintegrate her new identity into her world, the world pushes back, insisting
that her old identity is still valid. This kind of homeostatic resistance exists, to
a degree, with all change but it is particularly pronounced with rapid change.
The therapy group, conversely, acts to support the new change and provides
social validation for the new identity.
Recall that narrative therapy postulates that the self exists in the space
between us and the other. The group is a subculture that functions as a repre-
sentation of the whole culture. The Self that exists between me and the rest
of my therapy group has a solidity bestowed and validated by the subculture.
I have not been reinvented by myself; I have not even been reinvented in the
space between me and my therapist; rather, I know I am transformed because
the whole culture (the therapy group) endorses the new me.
The significant difference between the Reality B view of group therapy and
the traditional view is similar to the difference between the reality therapy
basic model and a more complex model from, say, psychodynamic or systems
psychotherapy. In the reality therapy model the client is seen as changing
simply because the charismatic therapist urges him to do so. The complex
techniques are not necessary—only the relationship and the urging. Similarly,
in group therapy the basic power of the group influence is seen as the domi-
nant factor. It does no harm in general to include more complex techniques
such as psychodrama or DBT but the Reality B therapist keeps her focus on
 The Other Royal Road 271

the simple pressure from the group to adapt to a new reality—the new reality
defined by the consensus of the group.
On the one hand, assertions about the power of the group to influence the
client are hardly new news; this is a factor that is acknowledged by virtu-
ally every experienced group leader. Conversely, accepting that this is the
important factor is different. Everything seems simpler. There is a more
relaxed sense in the therapist about controlling the flow of the group. And,
while attempting to track the feelings and reactions of multiple individuals
is always a challenge, there is also a sense of lightness as the therapist leans
into the power of the group.
Therapist charisma, of course, continues to be vital especially during the
“illumination” process where the client’s core issues are defined and high-
lighted. It is also helpful when increasing or decreasing the group pressure
on any particular individual. In addition, it can be very useful when meeting
individually with a member either to process a group experience, work on
bonding issues, or for another reason.
Process groups are an ideal environment in terms of the Frank model.
With some help from the therapist, the group quickly illuminates the core
issue and provides an explanation for it. The ritual grows naturally out of the
group environment and typically consists of exhibiting behaviors in the group
incompatible with the core issue or reporting that such has occurred outside
the group. The power of the intervention is amplified by the altered states so
easily achieved in the group environment. And there is the ability of a therapy
group to function as a “mini subculture” in terms of socially validating a new
identity.
Most important, however, is the raw power of the group to directly alter
the client’s worldview and identity. We are all programmed to adjust our
realities to fit the social environment of our chosen groups and companions.
Being fully aware of this central power—a power fully revealed as the Real-
ity B therapist strips away distracting details like techniques and client his-
tory—allows for sustained change with relatively little effort and resistance.

THE POWER OF SOCIAL VALIDATION

Being entirely honest with oneself is a good exercise.

—Sigmund Freud, Origins of Psychoanalysis (1895)

The power of social validation cannot be overemphasized. Everything that

is “me” is defined, restricted, and liberated by the ongoing feedback from
our social environment. Therapeutic wizards have the power to change client
272 Chapter 12

reality with a “wave of the mind.” That power requires a gifted individual. In
contrast, our social environment limits or liberates us with every encounter
and interaction.
Fortunately, it is relatively easy to access this power and to work with it.
This chapter illustrated many approaches that result in effortless, fluid, and
long-lasting change. This is not only the source of some optimism but it helps
free therapists from the crippling Apollonian assumptions that change is dif-
ficult, or change can only happen by releasing deeply ingrained traumas, or
change is only temporary and will always regress back to the former state.
The power of the group and the social environment to elicit easy change
is one of the “proofs” that we live and operate in constructed reality. And it
also supports the concept that our essential Self is ephemeral and fluid—a
realization that is a prerequisite to facilitating rapid and effective change.
The chapter on shifting identity argued that psychotherapy may be the most
efficient and transparent method of working with identity ever created by
human culture. Similarly, the therapy group is a unique window on the essen-
tial nature of the social construction of reality. There are other windows on
this as well, such as the study of cults and political movements, but the group
therapy experience allows us to understand and work with social influence in
an intimate and personalized way.
The actual environment of group therapy includes other opportunities for
therapist growth as well. First, it is a perfect laboratory for illustrating the nar-
rative therapy idea that my self exists in the space between me and others. In
group therapy, the clients rapidly shift from talking about their own issues—
and looking depressed and overwhelmed—to responding to the personhood
and the issues of the other—and looking centered and clear. The palpable
sense—to the therapist and the other group members—that these two selves
are radically different concretely demonstrates the freedom of construction-
ism. Seeing the client transform so quickly and radically gives everyone
present the sense that sustained health is possible for the client. Such shifts
naturally create a belief that anything is possible and that no one is hopelessly
and eternally stuck.
In addition, the group therapy environment is ideal when it comes to
conceptualizing treatment as a series of rituals. The therapist co-creates the
explanatory myth with both the client and the other group members. This
co-creation helps the therapist feel and experience the constructed nature of
explanations. And, while the healing ritual developed in group can literally
be anything—just as it is in individual therapy—in most group situations,
the ritual consists of demonstrating “healing” and “empowering” behaviors
directly in the group environment. This allows the therapist to witness and
participate in every part of the ritual, enhancing understanding and personal
experience.
 The Other Royal Road 273

The fact that altered states happen so easily in group therapy can be par-
ticularly helpful for the therapist as well. Especially for therapists who are
more experienced in Apollonian techniques, participating in Dionysian group
therapy can stretch both abilities and awareness. Moreover, the altered states
in group therapy are not limited to the clients; often the therapist gets altered
as well. There is something about sharing intimate and vulnerable material in
a group context that pulls everyone present into an altered state. Experienc-
ing that and learning to channel whatever part of that is helpful also tends to
stretch the therapist.
The group experience is also conducive to direct and indirect contact
with the Abyss. Sharing devastating, Abyss-related life events is common
in every type of therapy; however, in group therapy there is a palpable sense
that sharing these difficult events results in the entire community connecting
and offering to shoulder them together. It is an experiential response to the
Tillichian question at the edge of the Abyss: are we essentially alone in the
face of the devastating events of life or are we connected, hand in hand, as
we face them?
 Chapter 13

Dionysian Power
Sacred Space and Altered States

They who dream by day are cognizant of many things which escape
those who dream only by night.
—Edgar Allan Poe, “Eleonora” (1841)

The concept of Apollonian versus Dionysian has played a major role in this
book. Defining Apollonian and Dionysian in terms of the Nomological Net,
one can state that everything constrained by the Net is Apollonian and every-
thing outside of the Net is Dionysian. Culture, identity, and social interactions
are all defined by and stabilized through the Net. The Net defines normal
consciousness and secular space. Conversely, what lies outside the Net—or
what lies at the edge—can be defined as altered states of consciousness, the
Abyss, and sacred space.
At times the Abyss breaks through the Net spontaneously in the form of
epiphanies or pathologizing; at other times, humans use technologies—like
meditation, drugs, and hypnosis—to achieve these altered states. Whether
such states come spontaneously or are invoked by practices, they tend to be
disruptive. Sometimes this disruption is associated with terror, sometimes
with bliss, sometimes with knowing, and sometimes with confusion. Regard-
less, these purely Dionysian states are of great interest to the therapist because
they hold the power to rapidly transform the status quo and the existing iden-
tity of a client.
This chapter will focus on approaches that consciously attempt to move
the client into these Dionysian experiences. Using our analogy of the geogra-
phy of constructed reality, we would say that these experiences take place at
the edge of the Abyss, the place where the Net fades away and the darkness
begins. There is another word for this location: sacred space.

275
276 Chapter 13

Some of the most renowned work on sacred space was done by Mircea Eli-
ade, one of the outstanding religious studies scholars of the twentieth century.
Writing in books such as The Myth of the Eternal Return and The Sacred and
the Profane, he developed ideas about sacred time and sacred space which are
directly relevant to psychology and how people change. He begins his work
on the sacred by defining a key introductory concept: hierophany.

Man becomes aware of the sacred because it manifests itself, shows itself, as
something wholly different from the profane. To designate the act of manifesta-
tion of the sacred, we have proposed the term hierophany. It is a fitting term,
because it does not imply anything further; it expresses no more than is implicit
in its etymological content, i.e., that something sacred shows itself to us. It could
be said that the history of religions—from the most primitive to the most highly
developed—is constituted by a great number of hierophanies, by manifestations
of sacred realities. From the most elementary hierophany—e.g. manifestation of
the sacred in some ordinary object, a stone or a tree—to the supreme hierophany
(which, for a Christian, is the incarnation of God in Jesus Christ) there is no
solution of continuity. In each case we are confronted by the same mysterious
act—the manifestation of something of a wholly different order, a reality that
does not belong to our world, in objects that are an integral part of our natural
“profane” world. (Eliade, 1961, p. 11)

This definition of hierophany is phenomenological in that Eliade is simply

asserting that humans experience the eruption of the sacred into the profane
world and he is going to call these eruptions hierophanies. Next Eliade
defines homo religiosus, the man who puts spiritual experience at the center
of his life.

For religious man, space is not homogenous; he experiences interruptions,

breaks in it; some parts of the space are qualitatively different from others.
(1961, p. 20)

All of us experience the grinding sameness of daily life with its predictability,
its repetitive staleness, its tendency to gradually rob meaning and purpose
from existence. Eliade responds that the conscious observer perceives both
this process of degradation and the breaks in the fabric of reality where
something else shines through. In fact, without these breaks, humans are
essentially cast into a chaotic and meaningless existence.

Life is not possible without an opening toward the transcendent; in other words
human beings cannot live in chaos. (1961, p. 34)

Anticipating objections from those who reject the concept of the sacred,
Eliade turns to the question of whether the non-religious man actually exists.
 Dionysian Power 277

And in his arguments, one can hear echoes of the Tillichian statement that
man is the being who is “ultimately concerned.”

A non-religious man today ignores what he considers sacred but, in the structure
of his consciousness, could not be without the ideas of being and the meaning-
ful. He may consider these purely human aspects of the structure of conscious-
ness. What we see today is that man considers himself to have nothing sacred,
no god; but still his life has a meaning, because without it he could not live; he
would be in chaos. He looks for being and does not immediately call it being,
but meaning or goals; he behaves in his existence as if he had a kind of center.
He is going somewhere, he is doing something. We do not see anything reli-
gious here; we just see man behaving as a human being. But as a historian of
religion, I am not certain that there is nothing religious here.
I cannot consider exclusively what that man tells me when he consciously
says, “I don’t believe in God; I believe in history,” and so on. For example, I do
not think that Jean-Paul Sartre gives all of himself in his philosophy, because
I know that Sartre sleeps and dreams and likes music and goes to the theater.
And in the theater he gets into a temporal dimension in which he no longer lives
his “moment historique.” There he lives in quite another dimension. We live in
another dimension when we listen to Bach. Another experience of time is given
in drama. We spend two hours at a play, and yet the time represented in the play
occupies years and years. We also dream. This is the complete man. I cannot cut
this complete man off and believe someone immediately when he consciously
says that he is not a religious man. I think that unconsciously, this man still
behaves as the “homo religiosus,” has some source of value and meaning,
some images, is nourished by his unconscious, by the imaginary universe of the
poems he reads, of the plays he sees; he still lives in different universes. I can-
not limit his universe to that purely self-conscious, rationalistic universe which
he pretends to inhabit, since that universe is not human. (Eliade, 1973, p. 104)

For Eliade the Sacred is present for all human beings regardless of tendencies
to deny or dispute the presence of meaning and the existence of hierophanies.
Eliade goes further and argues that humans are archetypally aware of whether
they are in sacred or secular space and whether this moment is part of sacred
time or secular time.
Simple definitions of sacred space are concepts such as being in a church
versus outside one—or being in the wilderness versus being in the city.
Simple ideas of sacred time are concepts like Lent or Mardi Gras versus the
typical work week. Not content with these simple definitions, Eliade extends
these ideas by discussing the concept of sacred geography. More specifically,
wherever the Sacred manifests in the world becomes the center of the world,
the place of the axis mundi, the spot where heaven and earth intersect.

The experience of sacred space makes possible the “founding of the world”:
where the sacred manifests itself in space, the real manifests itself, the world
278 Chapter 13

comes into existence. But the irruption of the sacred does not only project a
fixed point into the formless fluidity of profane space, a center into chaos; it also
effects a break in plane, that is, it opens communication between cosmic planes
(between heaven and earth) and makes possible ontological passage from one
mode of being to another. It is such a break in the heterogeneity of profane space
that creates the center through which communication with the transmundane is
established, that, consequently, founds the world, for the center renders orienta-
tion possible. Hence, the manifestation of the sacred in space has a cosmological
valence; every spatial hierophany or consecration of space is equivalent to a
cosmogony. (Eliade, 1961, p. 63)

Certain experiences in the natural world effortlessly invoke the sense of

the Sacred. Philip Caputo, in the following quote, attempts to articulate the
implicit sacrality of the natural world.

Directly overhead the Milky Way was as distinct as a highway across the sky.
The constellations shown brilliantly, except the north, where they were blurred
by the white sheets of the Aurora. Now shimmering like translucent curtains
drawn over the windows of heaven, the northern lights suddenly streaked across
a million miles of space to burst in silent explosions. Fountains of light, pale
greens, reds, and yellows, showered the stars and geysered up to the center of
the sky, where they pooled to form a multicolored sphere, a kind of mock sun
that gave light but no heat, pulsing, flaring, and casting beams in all directions,
horizon to horizon. Below, the wolves howled with midnight madness and the
two young men stood in speechless awe. Even after the spectacle ended, the
Aurora fading again to faint shimmer, they stood as silent and transfixed as the
first human beings ever to behold the wonder of creation. Starkmann felt the
diminishment that is not self-depreciation but humility; for what was he and
what was Bonnie George? Flickers of consciousness imprisoned in lumps of
dust; above them a sky ablaze with the Aurora, around them a wilderness where
wolves sang savage arias to a frozen moon. (Caputo, 2004, p. 29)

Eliade agrees with Caputo and Momaday and in the following quote dis-
cusses the transmutation of the natural world into sacred space.

For those to whom a stone reveals itself as sacred, its immediate reality is trans-
muted into supernatural reality. In other words, for those who have a religious
experience all nature is capable of revealing itself as cosmic sacrality. (Eliade,
1961, p. 12)

Humans archetypally divide the world into sacred and secular. Daily life
besieges us with its dulling, deadening sense of the profane. In spite of this
dulling quality, the nature of the world exposes us to breakthrough experi-
ences of the sacred. These experiences have the capacity to become the center
 Dionysian Power 279

of our lives and to suffuse our world with purpose and meaning. However,
we need to be sufficiently awake and aware to discern the presence of these
hierophanies and to use the experiences to enrich our lives.
Secular space is the domain of the Nomological Net and sacred space is the
place “outside” the Net. Some might visualize it as the place where the Abyss
and the Net touch. Identity is fixed and solid in secular space and capable of
adapting fluidly and gracefully in sacred space. Sacred space is like Never-
land where a person can stay young forever. It is the Garden of Eden where
all is perfect and peaceful and no sin exists. For the client, immersion in
sacred space is equivalent to drinking from the Holy Grail, being enriched by
the golden city of Cibola, or being healed at the Temple of the Rock. Sins,
mistakes, and self-hatred are released there. One can leave sacred space with
talismans of power—such as a sword or a cup—which allow one to achieve
success in the secular world.
Obviously all these statements are metaphorical, not literal, but when one
speaks to a person who has climbed Mount Everest, or followed the Way
of St. James to Santiago, or spent a year meditating at a retreat in Southeast
Asia, they often summarize their experience with phrases similar to those
above. Last chapter discussed the use of rituals in group therapy. The pilgrim-
ages to sacred space, the immersion in the Holy, and the treasures brought
back on the return are also rituals—but the power of such rituals is amplified
by their association with the numinous.
For psychologists, most examples of the Abyss breaking through the Net
are associated with experiences of alienation, ennui, and despair. Eliade also
talks of breakthroughs but he is focusing on the oracular Abyss and its associ-
ated experiences of meaning, connection, wisdom, and bliss. Examine the fol-
lowing personal experience collected by the Religious Experience Research
Unit of Oxford. Note that it was a spontaneous experience; the speaker did
not seek it out nor did he invoke it via spiritual practices, prayers, or medita-
tion. It simply broke through the Net, just as the debilitating experiences of
the Abyss come without an invitation.

Often during my late 20s and early 30s I had a good deal of depression, not
caused by any outward circumstances. . . . At the age of 33 I felt I must be going
mad. I felt shut up in a cocoon in complete isolation and could not get in touch
with anyone. . . . Things came to such a pass and I was so tired of fighting that I
said one day, “I can do no more. Let nature, or whatever is behind the universe,
look after me now.”
Within a few days I passed from a hell to a heaven. It was as if the cocoon
had burst and my eyes were opened and I saw.
The world was infinitely beautiful, full of light as if from an inner radiance.
Everything was alive and God was present in all things; in fact, the Earth, all
280 Chapter 13

plants and animals and people seem to be made of God. All things were one, and
I was one with all creation and held safe within a deep love. I was filled with
peace and joy and with deep humility, and could only bow down in the holiness
of the presence of God. . . . If anyone had brought news that any member of my
family had died, I should have laughed and said, “there is no death.” It was as
if scales had fallen from my eyes and I saw the world as it truly was. How had I
lived for 33 years and been so blind? This was the secret of the world, yet it all
seemed so obvious and natural that I had no idea that I should not always see it
so. I felt like going round and telling everyone that all things were one and the
knowledge of this would cure all ills. . . .
Psychologically, and for my own peace of mind, the effect of the experience
has been of the greatest import. (Cohen & Phipps, 1979, p. 27)

Throughout history, individuals in search of healing, of redemption, and of

wisdom have sought the blessings associated with scared space. Not surpris-
ingly, a number of therapeutic and personal growth programs attempt to build
on these ancient traditions to accomplish their modern goals.
For purposes of this chapter, we can talk about programs and techniques
that approach sacred space externally and those that approach it internally.
Internal pilgrimages to sacred space involve experiences such as medita-
tion retreats, hypnosis, personal growth classes at places such as Esalen,
and taking ayahuasca in Peru. External approaches involve programs such
as Outward Bound which uses wilderness experiences to build character,
service programs—especially in foreign cultures—which attempt transfor-
mation through cultural immersion and opening the heart, and literal forms
of pilgrimage, such as going on the Hadj or reaching the South Pole on skis.
Some approaches blend the two such as a meditation retreat (internal) where
one also has the opportunity to receive the darshan (spiritual presence) of the
“enlightened Master” (external).

IN WILDERNESS IS THE PRESERVATION

OF THE WORLD

Climb the mountains and get their good tidings. Nature’s peace will
flow into you as sunshine flows into trees. The winds will blow their
own freshness into you, and the storms their energy, while cares will
drop away from you like the leaves of Autumn.
—John Muir, The Mountains of California (1875)

To illustrate the nature of an external encounter with sacred space, we will

use the Outward Bound program, and how it works with sacred space, as
our example. Outward Bound was founded in England during World War II.
 Dionysian Power 281

The British Merchant Marine Service was losing numerous ships as a result
of German U-boat attacks. They noticed that the older seamen were surviv-
ing the lifeboat experiences better than the younger seamen. This counter-
intuitive finding was explained with the theory that the older seamen were
hardier than the younger. The Outward Bound program was developed to
toughen up the younger seamen by impelling them into challenging experi-
ences. After the war, Outward Bound continued but changed its focus from
training young seamen to helping youths successfully master the adolescent/
adult developmental passage.
Outward Bound came to the United States in 1962 and established its first
school high up in the Colorado Rockies. This British import was quickly
influenced by two major American themes. First, the longstanding tradition
of Americans as hardy frontiersmen immediately surfaced. Second, and prob-
ably more important, the 1960s and 1970s saw the nascent environmental
movement take an enormous leap as backpacking, climbing, and adventuring
became commonplace. From mountain man, Japhy Ryder, in the Kerouac
novel Dharma Bums, to climbers in Yosemite Valley such as Yvon Choui-
nard, the world was full of new heroes who belonged in the mountains as if
they had been born there. John Denver was singing about Rocky Mountain
High and Edward Abbey was writing Desert Solitaire.
Outward Bound was no longer simply about building character; it had
evolved into a program staffed by idealistic Americans who did see wilder-
ness as the “preservation of the world” and who believed that the wilderness
experience had the power—through its numinosity—to transform visitors
and pilgrims. These young staff members did not believe that they needed to
make much of an effort with students to achieve these changes. In fact, they
had a saying, “The mountains speak for themselves,” which implied that they
simply needed to get out of the way and allow the sacred space to directly
transform the students.
To understand how an Outward Bound course functions, it is helpful to
describe its essential elements. While the Outward Bound experience has
been adapted for a variety of special populations, and operates in a variety of
environments, the “standard” course is still conceptualized as a three or three-
and-a-half week mountaineering course. Students are grouped into “patrols”
and accompanied by one or two instructors. The course is divided into four
phases:

1. Basic Expedition: Instructor travels with the group and teaches basic skills
such as backpacking, orienteering, first aid, and climbing.
2. Second Expedition: Students begin to travel on their own. More physically
demanding activities are included such as peak climbs, off trail travel, and
night hiking.
282 Chapter 13

3. Solo: Students spend three days alone with their journals. Most fast.
4. Final Expedition: Students travel in small groups without instructors
crossing miles of wilderness.

Research on Outward Bound reveals a very strong effect immediately post

course. Typical responses from students include statements like: “I found out
who I am,” “Having done Outward Bound, I feel like I can do anything!”
and “I learned so much about myself and others that I’ll never see the world
in the same way.” Parents report things like “my son came back a different
person,” or “my daughter says she really appreciates her family and we get
along so much better.” Psychological scales record improvements in things
like self-esteem and internal locus of control and decreases on pathological
measures such as depression and anxiety. The effect sizes are substantial but
they have difficulty being maintained over time, a factor which is discussed
in more detail in the summary section of this chapter.
These powerful outcomes are caused by a variety of factors, yet for our
purpose—understanding the impact of sacred space—the archetypal nature of
the Outward Bound course will be emphasized. Examine the following quote
from an earlier book that I wrote on Outward Bound (OB).

The seeker always experiences sacred space as highly numinous—it is pervaded

with a sense of power, mystery, and awesomeness. It clearly participates in a
transcendental plane of existence. Human beings—whose home is the earth—
can never stay there. In the first place, it lacks the prerequisites for normal
living. In the second, the seeker almost always has something important to
accomplish back in the real world.
Sacred space always leaves its mark on the seeker. Sometimes he comes
away with the memento of the Sacred space—perhaps a sword or a cup—but
often the mark is more internal. In any event, the seeker is irrevocably trans-
formed—he has entered the Sacred Space and is forever changed. The quality
of the transformation usually depends on the quality of the approach to the
Sacred Space. Those who have approached it properly, with full respect and
a clean spirit, are empowered in a positive manner. But those who have trifled
inappropriately with the power of the Sacred Space received the power mixed
with some kind of curse.
Finally, these changes are always magical and unexpected. Seekers do not
earn them in the sense that they deserve their rewards. The rewards are always
too great and too surprising to be anything other than free gifts from a higher
power.
Anyone who has spent much time in the wilderness can easily recognize the
parallels between it and the archetype of Sacred Space. Wilderness is difficult
to get to and difficult to travel through. One passes a series of tests in order to
exist within it. It is unlike the normal world in hundreds of ways. Above all, it
is pervaded with a kind of religiosity or mysticism—one of the most compelling
 Dionysian Power 283

things about nature is that it seems to implicitly suggest the existence of order
and meaning.
The power of an archetype is such that human beings are unconsciously
prepared to recognize a concrete manifestation of the archetypal pattern when
they encounter it in the world. According to Jung, the archetypes are literally
stamped into the human unconscious. They’re similar to instincts in an animal.
A student is as prepared to see wilderness as Sacred Space as a bird is prepared
to fly south for the winter.
The usefulness to Outward Bound of wilderness as Sacred Space is that this
archetype is inextricably linked with the concept of transformation and change.
Seeing the wilderness a Sacred Space means that the student has implicitly
accepted the possibility—or even the probability—that some kind of powerful
transformation may occur. This expectation of empowerment can exist in spite
of any limitations from his past because sacred space transformations are magi-
cal and undeserved. (Bacon, 1983, p. 53)

Recall that there is a dividing line between secular space and sacred space.
For OB that line is where the roads end and the wilderness begins. When stu-
dents arrive at a course, the bus drops them off and they begin with a one or
two mile run into the staging area just inside the wilderness boundary. Their
luggage is taken in by a four wheel drive vehicle. They are given special wil-
derness gear (packs, clothes, tarps, and so on) and the instructors inspect the
packs carefully to ensure that nothing symbolizing or embodying civilization
(e.g., electronics, cosmetics) is allowed. The experience is highly similar to
a pilgrimage where the pilgrim dresses in a simple (sacred) costume, travels
the road on foot, and takes little or no money or food.
During the first week of the course, the students are taught the “sacred
language” and the “devotional rituals” relevant to moving in the wilderness
and surviving comfortably. They learn what an “arête” (ridge) is and how
to move through a “col” (saddle or pass, often with no trail). They learn
how to navigate, rappel and belay, stay dry in the rain, and make bread.
They are often required to push themselves physically beyond their limits
and not only stay cheerful while doing it, but lend a hand to another who
might need it.
The experiences that make up the course are specially selected to have high
emotional impact. In fact, one famous concept embodying OB in particular
and experiential education in general is to attempt to “impel the student into
value-forming experiences.” Outward Bound loves to create moments where
there is high “perceived danger” and low “actual danger.” Rock climbing and
rappelling are obvious examples. And there is something grand about start-
ing a peak climb in the dark at 4 a.m., clipping in to a fixed rope crossing a
knife ridge with a thousand feet of exposure, and then summiting to a view of
mountains stretching in every direction as far as one can see.
284 Chapter 13

The OB course includes other kinds of high impact experiences that require
“adventuring in the inner world”: encouraging a friend when they feel too
tired to go on; confronting a difficult patrol member when their attitude
becomes negative; and accepting help from another. Jumping in a lake with
floating icebergs for a bath is common as is building a sweat lodge or learning
to cook apple fritters when one misses donuts too much.
The students live in close proximity to the instructor who is seen as part
human and part denizen of the wilderness—a kind of demigod. Instructors are
marked as different in a variety of ways. Their equipment is better; they know
the names of the flowers and animals; they can tell at a glance if the route is
safe or impossible; they are effortlessly skilled at climbing and wilderness
first aid, and their endurance is legendary. They speak differently and answer
some questions with stories, other questions with hints, and some questions
they refuse to address at all. They look different, more tanned, more fit and,
most of all, they project a sense that they belong—that they are completely
at home.
They are a little crazy by conventional rules. Hiking boots are required
equipment on an OB course but one instructor, during a Canyonlands desert
course, insisted on doing the entire course in flip flops. Naturally the students
assumed she must have a special relationship with the cactus gods and the
slickrock angels. One the first day of one course, the entire instructional staff
introduced themselves to the students wearing nothing but loin clothes. This
kind of craziness marks the instructor as a kind of divine madman—a person
no longer bound by conventional rules because they are living by divine rules.
The students are encouraged to reflect on their experiences and keep a
journal. The high point of this reflective activity is the three-day solo where
the students are taken to an individual camp site with nothing but a sleeping
bag, their tarp, their journal, and water. These sorts of “vision quest experi-
ences” are easily recognized as one of the oldest and most traditional ways of
inducing an altered state.
Most nights there are patrol meetings to reflect on and discuss the activi-
ties of the day. Often the students who have the deepest feelings about what
they have experienced speak first, and longest, and talk about how profoundly
they have been affected by something. This, of course, creates an atmosphere
conducive to reflection; more importantly, however, such sharing inspires the
other students to have their own deep feelings. This not only makes feeling
and sharing safe, it actually helps create deep feelings even in students who
are unused to experiencing the world on affective and existential dimensions.
As the students become dirtier, fitter, more skilled, and more independent,
they begin to feel like the instructors: that perhaps they too belong in the wil-
derness, in sacred space. The course structure encourages this by having the
students travel more and more on their own culminating in a final expedition
 Dionysian Power 285

which unfolds without any support from the instructors. By the celebration at
end of course, the students know in their bones that they are no longer outsid-
ers. They have typically forged deep bonds with other patrol members that are
expressed by the classic “you have to have been there to understand.” Fully
belonging socially is a wonderful accomplishment on its own but it is ampli-
fied by the concomitant sense that they also belong in the wilderness. And, of
course, to belong in the wilderness means that the students have recognized
their implicit divine identities.
At OB—and indeed in most programs that successfully work with sacred
space—the instructors are not creating the experience because they believe it
is therapeutic. Rather, the instructors themselves believe that the wilderness
experience is sacred, that the Outward Bound course is a full initiation into
sacred space, and that the students will change in spite of themselves because
they will be touched by the “Spirit.” Carl Jung made the following phrase
famous and prized it enough to use it as an inscription on his house and his
tomb: Vocatus atque non vocatus, Deus aderit—Called or uncalled, God is
present.
From the moment the students step off the bus they are immersed in a par-
ticular view of reality. They have come from secular space; they now inhabit
sacred space. Sacred space is guarded by “monsters at the gate.” At OB those
monsters are the trackless wilderness, the steep fields of snow, ice and rock,
and the powers of wind, rain, and night. The inner guardians are fear, doubt,
lack of resolve, and inability to give and receive help. The students encounter
these guardians—and with the assistance from the demigod, the instruc-
tor—gradually pass the tests and are admitted to sacred space. In sacred
space their past transgressions are forgiven and rewards are bestowed. Upon
return to secular space—the regular world—the students feel transformed
and they exhibit signs allowing others, such as parents, to bear witness to
that transformation.
Eliade’s concept of the Sacred “breaking through” the Nomological Net—
secular space—has remarkable implications for how people change. It is
virtually identical to Becker’s and the existentialists’ concept of the Abyss
breaking through human denial. Interestingly, examples of Abyss break-
throughs, such as the fear of death or the sense of existential alienation, are
never considered constructions or the result of programming. When a person
feels despair secondary to such breakthroughs, no one argues that these feel-
ings are due to the influence of society or are the result of some kind of belief
system. Instead, they are seen as the authentic experience of a person who—
either wittingly or unwittingly—is facing the ultimate truth about human
reality and destiny.
Contrast that with Eliade’s hierophanies—the breakthroughs where
humans experience the sacred directly. Such experiences are often assailed
286 Chapter 13

as constructions, wishful thinking, forms of denial, and the result of religious

programming. There is an assumption that the dark experience of the Abyss
is true and the connecting/affirming experience of the sacred must be a con-
struction, something that only exists as a kind of reaction formation to the
experience of primal terror. Obviously this double standard—if it is painful,
it must be real; if it is uplifting, it must be constructed—is simply an unsup-
ported assumption that is sustained by Apollonian ideas like “no pain, no
gain.”
Outward Bound and similar programs succeed at creating rituals based on
sacred space immersions and initiations. Tillich might call such programs as
a form of “living symbols” that point beyond themselves. For the client, they
create the same modest positive effect found in virtually all psychological
interventions. If the instructor is sufficiently charismatic, they can create an
above-average effect.
For our purposes, however, the attempt of the instructor to master the
sacred space dimension of the OB course has real potential in terms of
enhancing charisma. The OB course is associated with archetypal images
like pilgrimage, gates, guardians, receiving grace, reverence, and holiness.
Attempting to master outer sacred space experiences requires a level of
openness and surrender to accumulate the available charisma; it requires the
therapist to stretch in an unusual dimension to harvest the full potential of
what is available.

TRANCEFORMATIONS

A dreamer is one who can only find his way by moonlight, and his
punishment is that he sees the dawn before the rest of the world.
—Oscar Wilde, The Critic as Artist (1891)

The previous section described one way to enter sacred space via an outward
journey—a pilgrimage that takes place in the physical world but which leads
to an inner transformation. This section looks at ways to experience sacred
space via an inward journey.
As mentioned above, a Dionysian experience is one that lies outside the
domain of the Nomological Net. We tend to think of Dionysian experiences
as unusual; we are so accustomed to secular space and normal conscious-
ness that there is an implicit assumption that this is the default state—one
that is achieved effortlessly. Of course we acknowledge that we need some
help in terms of creating this “normal” state of consciousness. In large part
the net is formed and sustained by social interactions; in that sense, I help
 Dionysian Power 287

you sustain your sense of identity and reality and you help sustain mine. But
before becoming too comfortable with the Apollonian assumption that our
natural state is secular consciousness, we might recall the research presented
earlier documenting how easily the net can unravel if those around us begin
to behave in unpredictable ways.
How easy is it, in actuality, to sustain the secular state of consciousness?
This entire book has argued that the “basic” experience in life is the experi-
ence of the Abyss with all its chaos and meaninglessness. The net is super-
imposed on that. Based on this fact, it is more accurate to argue that altered
states occur when we relax—that they are our native state of consciousness.
As an example, examine what happens to most people when we are cut off
from others—when we no longer have their help in terms of sustaining the
net and supporting “normal” consciousness.
And we have the perfect—albeit horrible—natural experiment: solitary
confinement in prison. Solitary confinement is considered a terrible punish-
ment in part because it deprives the prisoner of the opportunity to have his
sense of reality and identity confirmed by another. Following are some of the
symptoms that can occur as a result of solitary confinement.

There are many ways to destroy a person, but the simplest and most devastating
might be solitary confinement. Deprived of meaningful human contact, other-
wise healthy prisoners often come unhinged. They experience intense anxiety,
paranoia, depression, memory loss, hallucinations and other perceptual distor-
tions. Psychiatrists call this cluster of symptoms SHU syndrome, named after
the Security Housing Units of many supermax prisons. Prisoners have more
direct ways of naming their experience. They call it “living death,” the “gray
box,” or “living in a black hole.” (Guenther, 2012)

Clearly Guenther is portraying solitary confinement as a way to invoke an

experience of the Abyss, with its dark capacities to destroy meaning, purpose,
and even identity itself. In a prison, one of the most horrible consequences
is forced immersion in experiences that will impel one into the Abyss. The
forced and unnatural disintegration of the Nomological Net is equivalent to
losing personhood, identity, and all connection.
Contrast that with experiences which are specifically designed to expose
one to the oracular and meaningful aspects of the Abyss—practices such
as meditation and hypnosis. The same Abyss, when invited with a willing
spirit, now has the potential for healing, insight, and existential experiences.
Of course this inner journey to encounter the Abyss is not without its own
challenges. For example, if you ask any meditation teacher what happens
when a beginner learns to meditate they will describe the experience as
follows.
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You will try to keep your mind focused on your breath or your mantra and
you will succeed briefly. Then you will discover that your mind has veered off
towards what you are going to cook for dinner, or the laundry that you have to
pick up later, or how much your knee hurts or your nose itches, or how rude your
boss was today. You will then remember you are trying to meditate and bring
the mind back to the object of meditation. And then it will slip back into your
unending stream of busy thoughts.
They say in India that the mind is like a monkey, always jumping from here
to there. Upon reflection, however, it is more like a drunken monkey who is not
just jumping but lurching to and fro in a stupor. And that is not quite enough:
really the mind is like a drunken monkey who has been stung by a bee and is
alternately jumping, lurching and screaming in pain.

In this amusing quote we see the meditation teacher describing the begin-
ner’s experience of meditation. This description can also be understood as the
desperate attempt of the mind to stay involved with as many threads of the
Net as possible to keep identity and reality stable. Gilligan calls this repeti-
tive connection to the Net the “orienting response” (2012, p. 36). He cites
daily life examples such as shifting postures, scratching, and looking away as
behaviors that are seemingly innocuous but actually designed to maintain the
dominance of the conscious mind.
Quieting the mind is not simply an experience of calmness and relax-
ation, it is an insidiously radical practice which disconnects us from the
Net and lets us experience reality without the Net’s intervening effects.
Normal consciousness—staying “in reality”—requires thinking Net-
related thoughts. Anything quieter, anything less Net-focused, quickly
becomes an altered state. These altered states can create “Abyss break-
throughs”—as in solitary confinement—or they can open the practitioner
to Eliade’s hierophanies. In this sense, meditation and the practice of
altered states are never “safe” practices; they always implicitly threaten the
world order. Examine the following quote on the contra-indications for a
meditation practice.

There are conditions and situations when meditation is contra-indicated. A use-

ful rule of thumb is that meditation should be used with caution whenever there
are concerns regarding reality testing, ego boundaries, lack of empathy, or rigid
over-control. For example, when treating a schizophrenic patient with active
psychotic symptoms, it may be inadvisable to include meditation as a compo-
nent of treatment, as reality testing may be impaired.
Similarly, meditation may be inadvisable in treating some personality dis-
orders (DSM-IV cluster B—antisocial, borderline, histrionic, or narcissistic)
which involve lack of empathy, as it could reinforce further preoccupation with
the self that characterizes those disorders.
 Dionysian Power 289

However, an experienced therapist who has developed personal skills with

meditation and other mind-body techniques can incorporate meditation into
most treatment protocols, given appropriate attention to preparation of the
patient. For example, the course author developed a multimodal holistic health
program for schizophrenic patients at a state psychiatric hospital which incor-
porated meditation without any adverse effects.
Since meditation can be a powerful tool for self-reflection, it can occasionally
produce an opening to the inner dimensions of experience that could be over-
whelming to psychologically fragile individuals. In addition, relaxation-induced
anxiety, where an individual unaccustomed to deep relaxation that often accom-
panies meditation and finds the resulting physiological release and attention to
internal sensations, perceptions, and images, to be a source of fearful anxiety-
producing apprehension, can occur in meditation as well as in other relaxation
techniques used in therapy. (Lukoff & Wallace, 1986, pp. 274–282)

Lukoff et al. are pointing out that when liminal people—individuals who
are poorly stabilized by the Net—meditate, they are more likely to evoke
Abyss-related experiences than sacred space experiences. However, for most
people who practice meditation, especially with the typical frames offered
by meditation teachers (e.g., don’t force anything, most people experience
relaxation and inner peace, meditation is good at dropping high blood pres-
sure and reducing pain, and you are participating in an ancient practice
that leads to wisdom and bliss), there is little risk. The biggest risk for the
average person is a sense of increased anxiety as they employ techniques
designed to minimize their contact with the Net. The second biggest risk, of
course, is boredom. Meditation usually takes a while before the practitioner
begins to have significant sacred space-related hierophanies. And in a culture
accustomed to intense and frequent stimulating experiences, patience is not
a common virtue.
All the practices that achieve altered states do so by minimizing and
extinguishing connections to the Net. Whether it is chanting, or meditating,
or contemplative prayer, or hypnosis, every one of these approaches uses
techniques that move the mind away from one’s normal identity and conven-
tional reality. In time, all of these practices elicit experiences of the Abyss,
sacred space, or both. And, in the hands of the experienced therapist, all of
these practices allow for rapid realignment of the client’s identity and sense
of reality.
In this section, we are going to use hypnosis as our example of an inner
approach to sacred space. Hypnosis has been chosen because it is a relatively
common therapeutic technique and it is not directly related to spiritual prac-
tices. Stephen Gilligan, who has been mentioned previously, is one of the
foremost practitioners of clinical hypnosis in the United States. A senior stu-
dent of Milton Erickson, Gilligan has worked hard to stay true to the essential
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Ericksonian approach while simultaneously integrating modern ideas of con-

structionism, the Hero’s Journey, and a more explicit approach to spirituality.
Gilligan begins his latest book on hypnosis, Generative Trance (2012), by
defining hypnosis as a natural versus an artificial state. It is not something cre-
ated or imposed by the hypnotist, rather, humans have a tendency to fall into
altered states whenever they stop paying attention to their immediate experi-
ence. He calls this paying attention, the “orienting response,” and notes that it
is required for humans to sustain their identity. As mentioned above, this “ori-
enting response” is the primary reason that meditation is so challenging. For
therapists, it should be symbolically seen as a person chanting a mantra that
goes something like: “I’m me. I’m still me. I’m me because I am mad at my
husband. I’m me because my elbow tingles. I’m me because I have to shop
for chicken for dinner.” What is implicit in this ceaseless orientation to the
Net is that if this string of thought is interrupted, the individual experiences
the actual fragility of their identity and worldview. In fact, Gilligan goes so
far as to say that “trance occurs whenever identity is destabilized” (p. 31).
Destabilization of identity can be positive or negative; in the sacred space
of trance one can encounter the oracular Abyss or the terrifying Abyss. In this
sense, Gilligan sees trauma as a form of negative trance and healing as a posi-
tive encounter with sacred space. Moreover, the definition of trance is highly
culturally dependent. Put more simply, the nature of the hypnotic trance is
constructed. The Christian who meditates experiences the sacred Heart of
Jesus; the Yogi encounters Siva; and the modern Buddhist achieves equa-
nimity, inner peace, and bliss. Gilligan explicitly rejects the “old-fashioned”
authoritarian model of hypnosis, replacing it with a more egalitarian model of
generative trance. But Gilligan could “resurrect” the state of “suggestability”
if he believed it would serve a particular client. Understanding the underlying
unity of the different altered states helps the therapist be more fluid and have
more options.
Gilligan sees everyone as entering and exiting trance states multiple times
per day whether they are aware or not. Simple examples such as driving
across the city and not remembering any aspect of the journey or not feeling
discomfort while we watch an engaging movie are daily life experiences.
Psychological strategies like “projection,” where encountering an older co-
worker can bring back feelings from my father, are also considered trance
experiences. Living in Gilligan’s world requires the therapist to see multiple
trance experiences pervading life; some individuals literally live more in
trance states than “normal” states.
As a healer, Gilligan sees trance as a state full of endless possibilities. The
client can go anywhere, feel anything, access any real or invented memory,
and be endlessly creative. Trance is the essential Dionysian experience; there
are literally no limitations on what might be imagined or developed.
 Dionysian Power 291

The first practical question about trance has to do with inductions; how
does the therapist help the client move from a normal state to a trance
state.

To develop trance, the orienting response needs to be relinquished. If you look

across cultures and through time, you will find two common (complementary)
trance induction principles used for this purpose. The first involves absorbing
attention in a singular focus. This might involve visually focusing on a candle
light, a symbolic image, a point in the environment, or an imaginary point.
Sustained concentration blocks the orienting response, which would be hyper-
vigilantly scanning a visual field, tense eyes moving in arrhythmic patterns. In
the absence of the stress-creating orienting response, attention can widen and
deepen into trance.
The second, and more common, trance development principle is to entrain
attention rhythmically on a repetitive pattern. This could be the chanting of a
mantra, the repeating of a body movement, the beating of a drum, repetition of
a prayer, singing a song, movement around a circle, the attunement to breathing,
long-distance running, and so forth. The rhythmic repetition signals the brain
that there is no new environmental information, so it’s safe to open deeper into
the world of relaxation and inner absorption. (Gilligan, 2012, pp. 36–37)

It should be clear from Gilligan’s explanation that hypnotic trance, deep

relaxation, self-hypnosis, and meditation are all different versions of the same
state: the disconnection of the mind from its habitual movement toward the
Net-defined reality. The differences between the altered states primarily come
from the set-up, frames, and expectations created between the therapist and
client or between the client and her culture. Meditation seems very different
from hypnosis because—as Gilligan has commented above—Westerners
see the altered state of hypnosis as one person, the therapist, controlling the
other, the client. Meditation, conversely, seems to be a solo experience or,
perhaps, a spiritual experience between the individual and their inner wisdom
or between a seeker and a divine force.
In the following example, Richard Bandler works with a woman who is
attending one of his workshops. The session begins with one of the client’s
arms elevated in midair and Bandler uses both the arm drop and the opposite
arm levitation to deepen trance.

Watch the changing focus . . . of your eyes . . . as you see the tops of your lids
slowly move down . . . over . . . eyes . . . only as fast as you become aware of
that need to blink. Take all the time you need, and allow your hand to go down
only as fast . . . as you become completely relaxed . . . in your own special way.
And it isn’t important how fast that hand goes down. It’s only important that it
goes down . . . at the same rate . . . and speed . . . that the other hand begins . . .
to lift up.
292 Chapter 13

Because there’s something that you want to learn about . . . and it isn’t really
important that anyone but you knows what that special learning is, because
your unconscious mind has known . . . all along . . . and if you’re going to learn
about it, it will be important . . . slow down! . . . to learn about it in a balanced
way. . . . And your unconscious mind knows what kind of balance will be
necessary. . . . That’s right. . . . It’s so useful and it’s really so important . . . to
allow your unconscious mind . . . to make changes and to have a learning experi-
ence . . . and new understandings . . . which you can use . . . for yourself . . . in
some way . . . which will be . . . beneficial to you as an individual human being.
Now, I don’t know . . . whether or not . . . you could begin to dream a
dream . . . which has within it the solution that your unconscious knows . . . will
give you what you want. But I do know that if and when you do begin that dream,
it won’t make any sense at all. And it’s not important that you understand. . . . It’s
only important that you learn . . . and you learn . . . exactly what you need to know.
Every night . . . Liz . . . you engage in the natural process of dream-
ing. . . . Some of those dreams you’re aware of . . . and some you’re not aware
of. . . . That’s right. . . . And I’m going to reach down now. . . . I’m going to lift up
your arm. . . . And I’m not going to tell you to put it down . . . any faster . . . than
you take all the time that’s necessary . . . to begin to build a conscious under-
standing . . . of what that means . . . to use your unconscious creatively. And
when your hand touches your thigh, you will slowly awaken . . . and you will
take that new understanding with you. In the meantime . . . there’ll be no need
to listen to anything else. But it is so pleasant to eavesdrop in a way that you
learn. (Grinder & Bandler, 1981, pp. 102–103)

Hypnosis is an ideal medium to illustrate Frank’s ideas about rituals; it’s also
a perfect demonstration of how new realities can be created by simple sugges-
tions. In this example, Bandler is teaching the workshop attendees one way to
do a hypnotic induction and then providing a variety of open-ended sugges-
tions that could be utilized to address therapeutic issues. The arm levitation
that occurs concurrently with the arm drop is both a method of deepening the
hypnotic trance and a “proof” offered to the client that, indeed, they are in an
altered state. Since they are altered, by definition they are in sacred space and
anything that occurs in trance will have sacred connotations.
Bandler then offers suggestions that establish that the client has an “uncon-
scious mind” that has special knowledge. This knowledge is now available
and will provide her with “special learnings” and “new understandings.”
These learnings can be used to alter a negative set of unconscious behaviors.
This change may be mediated through conscious understanding or it may be
initiated via the unconscious mind in a series of dreams.
Clearly what we have here is a Jerome Frank–style ritual. Like the group
therapy interventions, where the presence of others intensifies the experi-
ence, hypnosis creates a sacred context that amplifies the therapist’s sug-
gestions. Clearly, Bandler wasn’t individualizing the experience as much as
 Dionysian Power 293

is possible; this was a workshop demonstration, not a therapy session for a

specific client. But it is easy to imagine how he might have made his sugges-
tions more personified and accurate if this were a client who he had seen for
many sessions and who was working on a set of specific goals.
Returning to Eliade, he would argue that this woman has moved into sacred
space in her trance experience and been initiated into a new state of being, a
place where she has an ongoing channel to divine power. She now has access
to her unconscious mind; since this access is in sacred space, she essentially
has access to a divine oracle. In that sense, her identity is transformed. Previ-
ously she was simply human and lived in secular space with all the fears and
limitations implicit in that identity. Now, without denying the reality of her
secular experience, she simultaneously lives in sacred space and can access
the oracle when needed.
Now let’s examine another trance experience that works with these same
principles from a different angle. A forty-two-year-old woman, Joan, pre-
sented with a history of chronic migraine headaches. She had her own busi-
ness as a certified public accountant (CPA) and was very successful, working
long hours and making substantial amounts of money. She was married but
the couple had decided not to have any children. Approximately once a week,
she would get a migraine and essentially lose a day lying in a darkened bed-
room and taking pain medication; in spite of years of working with different
neurologists, no one had succeeded at budging this pattern. I decided to use
a hypnotic approach based on a Neurolinguistic Programming technique
named 6 step reframing.
This approach begins with a hypnotic induction. Once the client is in
trance, the “part” responsible for generating the headache is contacted
directly via ideomotor signaling. Ideomotor signaling is a hypnotic procedure
where the client is told that an unconscious part of their psyche has control of
a certain part of their body, typically a finger. If the part wants to reply “yes”
to a question, the index finger lifts by itself. If the part wishes to say “no,” a
different finger rises. This allows direct communication with an “unconscious
part.” In six-step reframing the client chooses the feeling that is responsible
for the yes-no communication; it is not limited to a finger rising.
Of course, typically parts which are responsible for generating headaches
are perceived as parts that have a dark or even malevolent relationship with
the main personality. In order to get such parts into dialog, the client must
begin by creating some kind of rapprochement with the alienated or dissoci-
ated part. This is generally done by urging the client to send benign and posi-
tive messages to the part.

Therapist: Joan, we need to begin by discovering why this part is sending you
headaches. But before we uncover its purpose, it needs to be willing to talk with
294 Chapter 13

you. I suspect that this part feels that you hate and resent it because you have come
to dread your headaches and see them as something that has, at least, partially
ruined your life. So we need to send a different message.
Begin by exploring around inside and get a sense about the presence of this
part. Reach out to it until you can feel it. It may reveal itself as a bodily sensation
like a dark cloud in the midsection. Or it might hear a voice or see an image of it.
It could be you at a younger age. Or it could simply be an amorphous feeling. Take
your time and nod when you can sense the presence of the part.
(After about 30 seconds, Joan gives a nod.)
Good, That’s right. OK, let’s begin dialog with it. Using your own words, I
want you to tell this part that you are really interested in getting to know it and,
especially, getting to know the purpose of sending you these headaches. Just say
that to it and wait for a response. You might sense that it is open to communicat-
ing with you or you might feel that it is blocked or held back or you might sense
something else. Let me know what kind of response you get to the message offer-
ing to communicate.
Joan: (after about 20 seconds of silence) I gave it the message but all I got back
was a kind of hostile silence.
Therapist: Like it doesn’t trust you?
Joan: Yes.
Therapist: OK, I want you to come out of trance so we can talk about this. Take
in a deep breath and slowly let it out and as you exhale, feel yourself coming back
up out of trance, your eyes getting ready to open, that’s right. All the way back.

Joan came out of trance and we spent a few minutes discussing all the times
that she had disparaged this part and how it must feel given years of being
portrayed as a malevolent force. After this brief discussion, Joan went back
into a trance state and prepared to address the “headache” part again. This
process—of moving out of trance and then back in—often results in subse-
quently deeper trance experiences.

Therapist: Again feeling free to use your own words I’d like you to tell this part
that you understand why it might not be willing to talk to you given the many
years you attacked it and put it down. But now, today, you are approaching with
a different attitude. You have a curiosity about whether you’ve misunderstood
this part. You wonder if it might have had a deeper purpose all along. And you
are truly interested in listening and understanding. Say that to the part and let me
know the feeling you get about its response.
Joan: (after a minute of silence) it really relaxed a lot when I told it that.
Therapist: OK, now we’re ready for the next step. I want you to ask the part to
send you a signal that you can detect, a signal that we can use to communicate.
It could be a body signal like increasing your heart rate or sending a twinge of
headache pain; it could be a visual signal like a flash of an image from your past;
 Dionysian Power 295

it could be something else. Just be very still and ask the part to send you a signal
you can detect. And let me know when you get the signal.

Joan: (after 30 seconds of silence) I got something. My neck muscles tightened

up like steel.
Therapist: Oh, yes. Do you have this feeling around your headaches?
Joan: Yes, I almost always do.
Therapist: OK, that sounds like the signal, all right. But we’re going to test it.
Please tell the part that we want to set up a signal system. If it wants to say “yes”
to a question, it should send the signal; if it wants to say “no,” it shouldn’t send
the signal and if it agrees, it should send the “yes” signal.
Joan: It already did. My neck feels incredibly tight.

This signal is an ideomotor response and is used just like the finger signals
described above. It is assumed that the signal is directly generated by the part
and allows for direct communication with this subconscious part.

Therapist: That’s good. So we’ve got a confirmation. Next question I want you to
ask is whether the part is willing to tell you the purpose that underlies sending the
headaches. If it is willing, it should send the “yes” signal.
Joan: (after 10 seconds): I’ve got a “yes.”
Therapist: Great. So now make your mind a blank—create a receptive space—
and ask the part to send you the purpose. Then simply observe. Something will
come in like a feeling, or an old memory, or a series of images. Sometimes the
parts send something literal—almost like a person talking to you. Simply be open
and let the part communicate.
Joan (after a minute of silence): I’ve got a memory of a time with my father back
in high school.
Therapist: OK, good. Take in a deep breath again and as you slowly exhale, feel
yourself coming back up to the surface, allow your eyes to open.

The image was a memory of a time when Joan had presented a poor report
card to her father. He was furious with her and had impressed on her that if
she didn’t go to a good college, her life would essentially be ruined and she
would amount to nothing. There was a memorable quote in the interaction—
something like “if you continue wasting your time and don’t learn how to
work hard, you’re going to be torn apart by the world.” Joan noted that ever
since, she had had a terribly guilty feeling if she ever slows down and relaxes.
She even added that this father wound was central to her decision not to have
children; she didn’t feel she could work at her current pace and find time to
be a mother. She noted that her husband kept telling her she needed to relax
more but she mostly ignored this advice.
296 Chapter 13

Therapist: So it sounds like this part believes that due to the fear instilled by
your father, you’ve been living a kind of driven life, one where any other activity
besides hard work makes you feel scared and guilty.
Joan: That sounds about right.
Therapist: And do you respect this purpose? Do you like having a part that is
standing up for balance in your life? Do you want to explore the side of being
human that is the opposite of being driven by fear?
Joan: Yes, I’ve sort of known this for a long time and I feel ready to deal with it.
Therapist: OK, then. Let’s go back inside. Take in another deep breath and, as you
exhale, feel your eyes closing. Go right back into the presence of the headache
part. And I want you to ask the part if you’ve understood the purpose correctly.
Using your own words, repeat the idea that its purpose is to help you find balance
in your life, to move you away from fear when you are not working hard, to help
you say “yes” to relaxing, enjoying and creating. If this is the purpose, have it
send a yes signal.
Joan (after 30 seconds): I got a very strong “yes.”
Therapist: Fine, now we need to find out if it is willing to stop sending the head-
aches if you adopt other behaviors designed to fulfill the purpose. Ask if it is
willing.
Joan: Another “yes.”

Joan came back out of trance and discussed what decisions and behaviors
she might offer the part that would embody its purpose. She settled on going
to dinner and a music concert with her husband and going for a walk on the
beach with her girlfriend three times a week. She went back into trance.

Therapist: Ask the part if it approves of each of these ideas. You should get a
“yes” for each one.
Joan: Got ‘em.
Therapist: Now ask the part If it will come up with one or two other things it
wants you to do to embody its purpose. You aren’t going to know what these
other things are; the part will take care of making these things happen. Ask for
a “yes” confirming that the part is adding its own new behaviors to the two you
have offered.
Joan: (after about a minute): Another yes.
Therapist: Take some time to thank the part. Show your gratitude but also include
your affirmation that you are serious about adopting this new life philosophy.
Pay attention to the response of the part. Does it feel open/closed, tense/relaxed,
whatever.
Joan: I got a real sense that it is very happy with this new plan.
Therapist: OK, one final question: but this time you need to address the whole
psyche not just the part. I want you to make a general broadcast. Ask inside
whether there is any other part that objects in any way to this idea of living a
 Dionysian Power 297

balanced life and alternating hard work with relaxation, creativity, and allowing
life to flow. Ask the question and then be very quiet. Pay attention to anything that
arises but particularly notice whether you get a sense of general relaxation and
relief or some kind of tension, fear or objection.
Joan: It felt kind of like there was a quiet but meaningful applause.

Joan returned in a week reporting no headaches. Three weeks later she had
the beginning of a headache but closed her eyes and told the part that it had
promised no headaches if she did her part. She noted that she had really
enjoyed the concert and the beach walks. I asked if she had any idea what
the part had picked to execute and she said, with mild embarrassment, that
she and her husband were having experiences in the bedroom that they had
never had before.
This case can be analyzed from a variety of perspectives. The construction-
ists would note that I made a variety of suggestions that shaped Joan’s experi-
ence as the dialog unfolded. I suggested the existence of the part, that it had
a purpose, that it would communicate if it were respected, and so forth. The
question of whether there really is a headache part that really had a purpose is,
of course, immaterial to the outcome. Joan and I co-created the reality and it
was sufficiently solid to stimulate mind-body responses that led to a diminu-
tion of her headache pain.
For this chapter, the important part of the case is that in her altered state of
trance, Joan had a direct experience of dialog with her unconscious mind. In
secular space, our unconscious mind in unavailable; in sacred space, we can
talk to the Gods, the Spirits, and, of course, the unconscious mind. We can
not only talk to it, but it responds back directly. The Oracle is the voice of the
Gods. It exists in sacred space and the seeker makes a pilgrimage to hear its
words. Joan made the inner pilgrimage and returned from sacred space with
a plan from the oracle—from a sacred source.

INTEGRATING THE SACRED INTO PSYCHOLOGY

To see a World in a Grain of Sand

And a Heaven in a Wild Flower,
Hold Infinity in the palm of your hand
And Eternity in an hour.
—William Blake, Poems from the Pickering Manuscript (1805)

Eliade tells us that we are all homo religiosus—the human who is predisposed
to divide the world into sacred space and secular space, the human who can
archetypally sense the presence of numinosity. Given that this is such a basic
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human experience, it is natural that psychotherapy should have evolved tools,

techniques, and approaches that maximize this experience and use it for heal-
ing and growth.
There are a great many approaches in psychotherapy that include a focus
on altered states, sacred space, and the Dionysian perspective. Most somatic
psychotherapies have strong altered state components; EMDR is another
example; most cathartic therapies also create profound altered states. Thera-
pies that focus on rituals like sweat lodges, and group therapies that intention-
ally create intense emotional states like encounter or psychodrama groups,
are additional examples.
At this point scientific psychology begins to be nervous. Numinosity is
difficult to measure and the presence or absence of sacred space cannot be
scored on a psychological test. Moreover, the hallmark of Dionysian thera-
pies is rapid and radical change. As has been pointed out in a number of the
chapters above, rapid change must be resisted by the dominant forces in the
culture. Rapid change implies that everything is falling apart and that noth-
ing is permanent. It suggests that the rules are not as solid as they seem. The
illusion of stability feels threatened. Finally, hypnosis and other altered state
experiences have been “owned” by fringe groups like entertainers, psychic
readers, and new age healers. These approaches are so Dionysian that Apol-
lonian scientists find them off putting at best and unethical, fraudulent and
exploitive at worst.
Yet in the geography of constructionism—which locates these approaches
and techniques at the edge of the Abyss—they belong to the human experi-
ence just as fully as CBT, electroshock, or communications theory. While this
may be true, their forbidden/dangerous aspects will have an effect on every
psychotherapist who chooses to explore the area.
The most basic approach is to simply define away the entire area. These
excessively Dionysian processes cannot be part of psychology because they
cannot be easily quantified by science and therefore should be left to fields
that have less rigorous methodologies such as religious studies. No one can
accurately determine how many psychologists endorse this approach but from
the relative paucity of studies in the area and the limited number of professors
specializing in altered states at major universities, it is likely that a significant
number of psychologists feel this way.
Conversely there are always some that leap at the chance to go wildly
Dionysian. These tools and approaches create high impact experiences that
are numinous and powerful. Many of these sorts of practitioners might do
well to recall Yalom’s belief that high impact experiences alone fail to create
meaningful change. An even more cogent critique comes from a well-known
Buddhist quote: “Be somebody before you become nobody.” This quote is
generally interpreted as a recommendation to take care that the foundations
 Dionysian Power 299

of your life are solid before seeking Dionysian experiences. On the one hand,
there is danger that the practitioner can get lost in such experiences given the
lack of foundation. Even more importantly, the saying suggests that some
of those who seek powerful Dionysian experiences may be afraid to build
healthy foundations and are hoping that a leap into numinosity will allow
them to bypass the basics. Not surprisingly, such a strategy is risky not only
for the therapist, but for his clients as well.
But if the therapist has taken care of his foundations, and if he is not satis-
fied with the idea that science is the one and only valid epistemology for psy-
chotherapy, then it is inevitable that he will eventually encounter sacred space
and the numinous. Eliade tells us that hierophanies abound in the world. Rec-
ognizing them and responding to them allows us to experience sacred space.
And these experiences inform how we do psychotherapy.
It is never necessary to become adept at the overtly Dionysian approaches
described in this chapter; the research clearly indicates that one can achieve
superior functioning given a sincere affiliation with any school or approach,
even a school that overtly precludes Dionysian techniques. But for many,
such limitations make no sense. If humans are regularly having altered states,
healthy ones that lead to healing, and damaging ones—like trauma—that lead
to suffering, it is natural to want to become expert in such experiences. And
that, of course, is what the approaches in this chapter offer.
It should be noted that this same rapid change does not come free of
charge; put another way, the faster a client changes, the more her regular
world will resist the change—homeostasis—and attempt to move her back
into her chronic level of functioning. The Net never supports change; it sup-
ports continuity. So after rapid, positive change, the Net operates to return the
client to her previous state. Even positive forces such as caring friends or a
loving family may find it difficult to accept and support rapid change.
At one point in my career, I was the head of research for Outward Bound
USA. Not surprisingly, when measured over time, OB achieved the same
kind of results as other therapeutic interventions: a modest, positive outcome.
Of course, the estimate of the level of change at the end of the course was
much higher; as mentioned above, comments such as “I’m a completely dif-
ferent person” and “This was the most powerful experience of my life” were
very common. Unfortunately, that level of transformation was not sustained.
Once, when discussing the results in our small research unit, one person
made the statement: “Outward Bound is good for the students, but it is
transformative for the instructors.” The act of unconsciously functioning as
a “demigod” in sacred space was an even more profound experience than
simply attending the course. Immersing oneself in the sacred—whether in
external form or internal—can be a profoundly moving experience for the
therapist. This hearkens back to the concept that performance of certain
300 Chapter 13

psychotherapeutic techniques has more power to change the therapist than

the client.
To me, one of the great mysteries of the research literature is how a thera-
pist fails to improve due to experience in the room. Virtually every therapist
reports profound experiences of connection, wonder, open heartedness, and
meaning on a more-or-less regular basis. How could repeated exposure
to these experiences fail to make more experienced therapists superior to
newcomers?
Perhaps it is the hesitancy about adopting a sacred worldview and the
resistance to using sacred language. Once again, this is Yalom’s argument:
an altered state without an appropriate frame fails to lead to growth. Scientific
psychology permits the therapist-client bond to exist and, of course, strongly
supports it. But there are few schools of therapy that teach the therapist or the
client that psychotherapy often leads into sacred space. The Informed Consent
Form does not include a caution that “some psychotherapeutic techniques
may create epiphanies and others might lead to spiritual experiences.” Given
that psychotherapy is part of the perennial philosophy, and that philosophy
predicts that inner exploration inevitably leads to sacred space, perhaps one
of our largest failings is that our scientism is hindering the maximization of
our experiences—both the client experiences and the therapist experiences. It
is possible that both are having “spiritual” experiences, but without appropri-
ate expectations they occur in a vacuum—without a meaningful label they
fail to be fully integrated.
Earlier chapters have pointed out that the evolutionary aspect of the Til-
lichian model requires one’s ultimate concern to evolve as appropriate across
the life span; integrating the concept of the sacred and the numinous into the
ultimate concern certainly fits the evolutionary model. This Dionysian chap-
ter also highlights the deliberate practice approach, the concept that practi-
tioners tend to concentrate on their strengths and systematically neglect their
weaknesses. In this sense, Whittaker and Farrelly urged therapists to become
comfortable with the uses of power in therapy, pointing out that some thera-
pists have neglected the Apollonian. As one might expect, other therapists
have similarly neglected the Dionysian.
This chapter on overt Dionysian approaches asks us to confront our fears
at a deeper level. As has been discussed, these approaches lie at the edge of
the Net and the beginning of the Abyss. The edge of the world is the place
where one might fall off and be lost forever. Dionysian psychotherapeutic
approaches similarly lie at the edge of the psychotherapeutic world. Psy-
chology has made certain efforts to integrate these approaches, in part by
providing categories such as transpersonal psychology and hypnotherapy.
This attempt to name or categorize operates partially to contain the danger-
ous aspects of these tools. But for many in psychology, the naming is not
 Dionysian Power 301

sufficient; the numinous continues to mark the edge of the known world, the
place where “angels fear to tread.”
For therapists seeking to maximize their charisma in order to be more
effective with their clients these approaches mark an important fork in the
road. Go forward and bear the risk of slipping off the edge or stay behind and
wonder what opportunities for growth may have been sacrificed. With all the
discussion of the pros and cons of Dionysian change perhaps the best guid-
ance comes from the modeling of the therapeutic wizards. Their acknowl-
edgment—consciously or unconsciously—of their role as key individuals
inevitably draws them toward Dionysian approaches. They are compelled to
push the limits of the power that comes through them, to wonder what might
be possible if they cooperate with it fully.
We have already discussed fearing the power of the Apollonian; it is a
tremendous responsibility to say to a client, “You’re going the wrong way.
Reverse course and do the right thing.” Similarly, it is an equally daunting
responsibility to embrace Dionysian power. To say to a client: “Infinite possi-
bilities abound. There are doors surrounding you—doors that lead to healing
and rapid change. I have been through these doors and invite you to join me
on such a journey.” The ability to say something like that to a client—and to
say it from a firm foundation—marks the therapist who is prepared to step up
to the possibilities of Dionysian healing. Pushing this experience to the limit
enhances therapeutic charisma.
 Chapter 14

The Spiritual Path

Turn away no more;

Why wilt thou turn away?
The starry floor,
The watery shore
Is given thee till the break of day.
—William Blake, Songs of Experience (1794)

Continuing the metaphor of exploring the geography of constructed real-

ity, this chapter on spirituality is centered on experiences, approaches, and
practices which arise secondary to leaping into the Abyss. The last chapter
on sacred space was focused on experiences at the edge of the Net and the
Abyss. This chapter goes further and follows those who have fallen off the
edge of the world.
Many writers have taken care to distinguish religion from spirituality.
Using the language of this book, religion consists of Apollonian rules and
structures that essentially work to sustain the Net; spirituality consists of
experiences, insights, and perceptions that arise from encounters with the
Abyss. Put in terms of Kohlberg’s developmental hierarchy, religion oper-
ates at the Conventional stage of moral development and spirituality operates
at the Post-Conventional. Put in Tillichian terms, religion defines faith as an
unsubstantiated belief and spirituality defines faith as a relationship to an
ultimate concern.
Before we can advance very far, it is important to address the resistance
present in many therapists when it comes to working directly with a client’s
spirituality. Imposing the therapist’s religious beliefs seems too much like
evangelizing, too close to violating the client’s individuality. In addition,
using a spiritual model is often problematic because many therapists have
303
304 Chapter 14

difficulty understanding and respecting the client’s specific spiritual path.

Finally, religiosity is often identified with the conservative values and the
oppression of certain liminal groups and these stances and actions are anti-
thetical to many psychologists. Pargament and Faigin (2012) comment:

Helping clients access their own religious resources is unfamiliar territory for most
psychotherapists. For example, as a group, psychologists are considerably less reli-
gious than the general population (Shafranske, 2001), and therefore often unaware
of the wealth of resources that are contained in the world’s religions. This problem
is compounded by the fact that only a small percentage of graduate programs in
clinical psychology provide students with any training in religion and spirituality
(Brawer, Handal, Fabricatore, Roberts, & Wajda-Johnston, 2002). But the problem
may go beyond unfamiliarity. From Freud to Skinner to Ellis, there is a long tradi-
tion of religious antipathy in the field, perhaps growing out of its efforts to establish
itself as a “hard science” and distinguish itself from its disciplinary kin—philoso-
phy and theology. Stereotypic notions of religion as a pacifier, a defense, or a form
of denial are still commonplace among mental health professionals, even though
these stereotypes are not empirically supported (Pargament, 1997). It would be
more accurate to describe religion as a potential resource for many people. (p. 313)

Pargament and Faigin are, of course, correct when they document the dif-
ficulty that many psychotherapists experience when working with religion; if
anything, they can be accused of underestimating the problems. For example,
they fail to discuss the ongoing “war” between science and religion. In a
previous chapter, the terms premodern, modern, and postmodern were dis-
cussed. These terms define the source of authority for the Apollonian task of
constructing the cultural net. The modern perspective argues that science has
the authority to determine the collective Net; being premodern implies that
religion has the largest voice, and so on. Obviously, there is a huge strug-
gle—particularly between religion and science—about which camp shall be
granted the final authority. Premodern determined the composition of the Net
before the 1700s; science gets a major say currently (although religion is cer-
tainly continuing the fight), and postmodern is simply a set of ideas—mostly
at universities—that has significantly less power when it comes to defining
the Net.
It is important to note that this struggle is all about the collective nature
of the Net. Neither of the two dominant approaches has to do with healing,
therapy, therapist efficacy, or therapist evolution. They are both about author-
ship of the collective agreement about how our culture defines reality and
ultimate authority. Both approaches are championed by Apollonians who are
interested in imposing their worldviews on the rest of the culture.
Psychology, of course, is smack dab in the middle of this war and
embraces implicit assumptions that anything “scientific” is good and anything
 The Spiritual Path 305

“religious” will return us to the Dark Ages. It is not a far stretch to argue
that this political and existential struggle has been partly responsible for psy-
chology’s ability to ignore the research results; admitting that the research
results prove that clinical psychology is “not scientific” feels like an unbear-
able capitulation. The collective denial of psychology about the research is
ironically similar to the collective denial of certain religious authorities on
evolution.
This book, of course, adopts a postmodern perspective and this chapter
is essentially about spirituality, not religion, but it is almost impossible not
to get caught in the “war” when discussing such topics. Put another way,
spirituality exists across all three historical dimensions but it is so interwoven
with religion that it is difficult to see it as sui generis—the thing in itself. And
in this confusion the baby is thrown out with the bathwater and the impor-
tance of spirituality is lost in the maelstrom. Einstein (2011), who, of course,
embodied the scientific perspective nonetheless managed to differentiate
between the two principles when he famously said:

Then there are the fanatical atheists whose intolerance is of the same kind as the
intolerance of the religious fanatics and comes from the same source. They are
like slaves who are still feeling the weight of their chains which they have thrown
off after hard struggle. They are creatures who—in their grudge against the tra-
ditional “opium for the people”—cannot bear the music of the spheres. (p. 97)

Returning to Pargament and Faigin’s point about the benefits of working with
client religiosity, imagine the usefulness of being able to function effectively
within the sphere of the client’s own spiritual beliefs. Go further, and imag-
ine being able to encourage an extension of their beliefs. Given that virtually
every spiritual and religious approach urges—or commands—its followers
to adopt exemplary, prosocial behaviors, the spiritually oriented therapist
can align herself with these values. More specifically, therapists frequently
recommend healthy choices and behaviors: be honest, persevere when you
are challenged, and give to others. How helpful can it be to add, “I’m not
only recommending these ideas to you but you made a covenant with God to
behave this way. Don’t you take that promise seriously?”
On another level, many religious teachings directly address the chronic
neurotic impulses of certain clients, particularly the self-destructive strate-
gies of personality disorders. There are spiritual teachings on topics ranging
from taking responsibility, communication strategies, social isolation, dealing
with guilt and self-deprecation, and how to trust. But where spirituality truly
shines, of course, is in its teachings about anxiety. Whether the client is more
conservative in his beliefs and endorses the idea of an afterlife or whether
he believes in the concept of “no self,” spiritual approaches to anxiety offer
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a perspective on dealing with the uncontrollable and the unpredictable that

significantly outshines any psychotherapeutic approach. Being able to say
something like, “You have surrendered to God and put yourself in his hands.
It’s normal to have doubt and fear about whether you are loveable and
whether you will be supported. You can buttress your faith and your covenant
by attending church and Bible Study and especially by listening to stories of
other members of your faith who can testify about the protection of the Lord.”
On a higher level, when clients are discussing motivation, meaning and
purpose, spirituality again has something special to contribute. The human-
istic and existential answers that are psychology’s typical offerings pale in
comparison to ideas and concepts based on thousands of years of religious
contemplation. Pargament and Faigin (2012) summarize some research that
bears on this topic:

It could be argued that religion does not add anything distinctive to the mix of
coping resources people can draw on when they encounter major life stressors.
After all, religious and spiritual support could be viewed as merely examples
of more general support. Transcendent meaning systems could be understood
as simply one subset of secular meaning systems. Yet, several empirical studies
suggest that religious resources make unique contributions to health and well-
being, even after accounting for the effects of secular coping resources. For
instance, working with a national sample of elders, Krause (2006) compared the
role of emotional support received from church members with the emotional
support received from nonchurch members as buffers of the effects of financial
strain on self-rated health. Whereas church-based emotional support emerged
as a buffer, secular support did not. Interpreting these findings, Krause empha-
sized the distinctive character of church-based support: It is particularly helpful
because it is enacted in a group that shares a spiritual worldview and commit-
ment to God, a common set of sacred beliefs, values, and coping methods,
shared religious principles, rituals, and memories, and a support that is “imbued
with the mantle of religious authority.” (p. 314)

Knowledge of the religious worldview significantly assists reframing when

working with spiritually inclined clients. However, while these examples
may be compelling, they are unavailable to many therapists unless they can
find an ethical and authentic way to access their own spiritual beliefs. Even
therapists who are very spiritual can find it difficult to bridge the gap between
their beliefs and the beliefs of a client that seem immature, wrong, oppressive,
or limited.
This chapter has the same goals as preceding chapters: to define a set of
psychological practices in the context of the geography of constructed real-
ity and to discuss particular approaches to mastering those practices that can
enhance the therapist’s charisma. This chapter is somewhat different than
 The Spiritual Path 307

preceding chapters in that some of the technology does, indeed, come from
psychology but many of the practices have originally been developed by
various spiritual traditions. Is it proper to include such techniques in a book
focused on enhancing psychotherapeutic outcomes?
Three responses come to mind. First, psychology has been integrating
these kinds of techniques for many years and that integration appears to be
strengthening, particularly in the area of Buddhist psychology and medita-
tion. Second, psychology is as much a part of the perennial philosophy as any
other approach to understanding the human condition. The perennial philoso-
phy argues that every serious inquiry into meaning and happiness will have
much in common with all other serious inquiries. Hence, there can be open
dialog between psychological techniques and spiritual techniques.
But it is the third reason that is the most important. This book has been
attempting to answer the question: “if psychotherapy really operates in
constructed reality, what are the full implications for improving therapist
outcomes?” The moment we recognize that the vast majority of clinical psy-
chology is in constructed reality, we are forced to discard scientific boundar-
ies; we can no longer say that psychology can only operate in areas that can
be measured, replicated, and assessed. Instead, we are forced to examine the
full range of human experience and that, of course, includes the spiritual. It is
no accident that in constructed reality, ritual replaces technique. And ritual is
a word with profound spiritual associations and connotations. Construction-
ism forces us to address the place of formal spiritual practices in psychology.

THE PATH OF WISDOM

How can you prove whether at this moment we are sleeping, and all
our thoughts are a dream; or whether we are awake, and talking to one
another in the waking state?
—Plato, The Dialogues of Plato (1907)

Every constructionist is already part way down the path of wisdom. All
wisdom traditions share the concept that achieving wisdom requires learning
to free ourselves from conventional assumptions and programmed think-
ing. Taking one’s beliefs apart generates the experience of emptiness—the
Abyss—and results in a perspective on normal human functioning that gener-
ally disparages simple answers to existential questions. Moreover, it brings
real clarity about fundamental reality versus constructed reality. There are
various words that describe the confusion that ensues when one confabulates
the two; some words characterizing this distressing state include Maya (illu-
sion), Lila (Divine play), and the Wheel of Samsara (birth and death).
308 Chapter 14

Of course, there is no use in undertaking such an examination unless

the result somehow leads to enhanced happiness and satisfaction. Hence,
the concepts in chapter 4—“A Place to Stand”—become prominent. In all
wisdom paths there is an explicit promise that pursuing wisdom—and dis-
puting that which is programmed and impermanent—will lead to some kind
of truth, bliss, and inner peace. This is typically supported by reports from
advanced seekers, individuals who have achieved direct inner experiences of
harmony and balance. As an example, please review the following experience
described by Eckhart Tolle, the author of The Power of Now. Note that his
experience occurred following the classic wisdom path question “Who am I?”

For most people, spiritual awakening is a gradual process. Rarely does it hap-
pen all at once. When it does, though, it is usually brought about by intense
suffering. That was certainly true in my case. For years my life alternated
between depression and acute anxiety. One night I woke up in a state of dread
and intense fear, more intense than I had ever experienced before. Life seemed
meaningless, barren, hostile. It became so unbearable that suddenly the thought
came into my mind, “I cannot live with myself any longer.” The thought kept
repeating itself several times. Suddenly, I stepped back from the thought, and
looked at it, as it were, and I became aware of the strangeness of that thought:
“If I cannot live with myself, there must be two of me—the I and the self that
I cannot live with.” And the question arose, “Who is the ‘I’ and who is the self
that I cannot live with?” There was no answer to that question, and all thinking
stopped. For a moment, there was complete inner silence. Suddenly I felt myself
drawn into a whirlpool or a vortex of energy. I was gripped by an intense fear,
and my body started to shake. I heard the words, “Resist nothing,” as if spoken
inside my chest. I could feel myself being sucked into a void. Suddenly, all fear
disappeared, and I let myself fall into that void. I have no recollection of what
happened after that.
The next morning I awoke as if I had just been born into this world. Every-
thing seemed fresh and pristine and intensely alive. A vibrant stillness filled
my entire being. As I walked around the city that day, the world looked as if
it had just come into existence, completely devoid of the past. I was in a state
of amazement at the peace I felt within and the beauty I saw without, even
in the midst of the traffic. I was no longer labeling and interpreting my sense
perceptions—an almost complete absence of mental commentary. To this day, I
perceive and interact with the world in this way: through stillness, not through
mental noise. The peace that I felt that day, more than 20 years ago, has never
left me, although it has varying degrees of intensity.
At the time, I had no conceptual framework to help me understand what had
happened to me. Years later, I realized that the acute suffering I felt that night
must have forced my consciousness to withdraw from identification with the
unhappy self, the suffering “little me,” which is ultimately a fiction of the mind.
This withdrawal must have been so complete that the suffering self collapsed
as if the plug had been pulled out of an inflatable toy. What was left was my
 The Spiritual Path 309

true nature as the ever present “I AM”: consciousness in its pure state prior
to identification with form. You may also call it pure awareness or presence.
(Simon, n.d.)

The Tolle experience successfully captures the flavor of the path of wisdom.
Fear is gone, replaced by a sense of stillness and presence. Tolle is talking
about living in the world without the intermediary effects of the “Net.” Note
how he repeatedly uses “Abyss” language. Life seemed meaningless, barren,
and hostile; clearly, Tolle was at the edge of the Abyss. Then he falls into a
vortex of energy that sucks him into the void. This is a clear example of the
perennial philosophy, the philosophy that argues that mystical experiences
across varying traditions are phenomenologically identical. Experiences like
this are self-validating and appear to contain answers to the mystery of life.
Each great religion has its own version of the path to wisdom and the
perennial philosophy suggests they are roughly equivalent. In that sense, we
can assume that any path to wisdom from one of the great religions conveys
the essence of seeking God via wisdom. We will use the Buddhist path as
our primary example of a wisdom path, partly because it is well organized
and relatively easy to understand and partly because it has made such great
contributions to psychotherapy in recent years.
Understanding Buddhism begins, of course, with an understanding of the
Four Noble Truths: the existence of suffering, the cause of suffering, the truth
that suffering can be removed, and the way of removal. Makransky (2012)
describes “suffering” as follows:

(Buddhism describes) three levels of suffering: (1) obvious suffering, (2) the
suffering of transience, and (3) the suffering of self-centered conditioning.
The suffering of self-centered conditioning underlies the prior two. This form
of suffering is inherent in the mind’s subconscious attempt to create from the
impermanent flow of its experience the impression of a substantial, unchanging,
and separate sense of self surrounded by a stable world. The mind’s ongoing
attempt to fabricate such a reified, unchanging impression of self and world, in
turn, conditions numerous anxious patterns of thought and reaction: clinging
to whatever seems to affirm a fixed, unchanging self and its world, fearing or
hating whatever seems to threaten it (see chapters 9 and 13). To oscillate uncon-
trollably through such feelings in reaction to our mental constructs of self and
others is the suffering of self-centered conditioning. (p. 62)

Essentially the Buddhists are agreeing with Becker when they describe the
“obvious suffering” inherent in being embodied and having a destiny to die.
The second level of suffering describes the futility of searching for happiness
by seeking pleasure and avoiding pain—indulging in strategies motivated by
desire and fear.
310 Chapter 14

However, it is the third level of suffering, “self-centered conditioning,”

which Makransky believes is the most important level of suffering—so
important that it is a foundation for all other suffering. Reread the italicized
sentence in the quote. Examining it closely reveals that it is virtually identi-
cal to the Apollonian commitment to sustaining and supporting the Nomo-
logical Net. This entire book is focused on understanding the implications of
this definition of suffering for helping clients and for being a more effective
change agent. Buddhists might argue that psychology has yet to develop a
treatment system that adds value because all of its systems are implicitly
founded on “clinging to whatever seems to affirm a fixed, unchanging self
and . . . world.” Moreover, practitioners fail to improve from practice because
they do not examine the underlying assumptions of their approach—assump-
tions that covertly encourage “the futile attempt to get, have, and hold onto
pleasant things as if they could be a stable source of security and well-being.”
Following this detailed definition of suffering, Buddhism moves on to the
fourth Noble Truth, the way of removing suffering. This removal consists of
the concrete practices which lead to the cessation of suffering. Chief among
those practices are mindfulness and meditation. Every time reality is reified,
it supports suffering; every time Self and Reality are experienced as fluid—no
Self and emptiness—it supports wisdom. Wisdom practitioners are enjoined
to witness this dynamic in every aspect of their life from meditation, to work,
to relationships.
Mindfulness begins with meditation practice where the meditator observes
and witnesses all the activity of the mind and body moving across the sen-
sorium. Through an intention to simply observe and not generate thoughts
and feelings, the meditator becomes aware that the thoughts and feelings are
being generated by themselves; in other words, they are coming from “non
self.” In this sense, mindfulness and meditation support the concept of non-
identification with thoughts and feelings. Reexamine the earlier quote from
Tara Brach (2012) on mindfulness:

In the simplest terms, mindfulness is the intentional process of paying attention,

without judgment, to the unfolding of moment-to-moment experience. It is the
opposite of trance, a word I use to describe all the ways in which we—therapists
and clients alike—live inside a limiting story about life. (p. 37)

In this quote, Brach is pointing out that the same process that is applied dur-
ing formal meditation can be employed in normal life. In meditation there is a
process of focusing and observing punctuated by forgetting that one is medi-
tating and becoming caught up in the thoughts and feelings. Brach cautions
against “trance,” the process where one “forgets” to be mindful and begins to
live as if all the thoughts and feelings are real.
 The Spiritual Path 311

The Brach quote bridges the gap between formal sitting meditation and
what is often called meditation in action. Meditation in action is the practice
of observing daily life using the same principles employed in sitting medita-
tion. More specifically, the practitioner pays attention to all the experiences
of daily life, both the inner life with attendant feelings, attachments, and
thoughts, and the outer life with relational encounters, successes and failures,
danger, and pleasures. And, just as in meditation, the practitioner regularly
loses focus, identifies with the inner and outer world experiences, and “goes
into trance.” To minimize these distracting experiences, meditation in action
builds from the simplest experiences (sitting and walking meditations), to
moderately complex ones (e.g., cooking and cleaning meditation), to complex
situations (e.g., workplace and relationship meditations) to the most challeng-
ing (meditation during desire, fear, and conflict).
This practice of meditation in action is available to every practitioner,
twenty-four hours a day, and in every situation. Although it may be intro-
duced in a hierarchical order from simple to complex, in reality, every
moment of life has the same opportunity for presence, awareness, detach-
ment, and openhearted compassion.
Buddhism and its chief practices essentially deprogram the world and the
self. In that sense, they are an embodiment of constructionism. Interestingly,
however, constructionism stops with the world disassembled. Everything is
taken apart but there are no implications about what to do next. Buddhism
argues that this deconstruction has implications for the heart, for connection,
and for compassion. Makransky (2012) comments:

As noted, the sufferings of transience and self-centered conditioning are medi-

ated by unconscious habits of reification—the mind’s attempt to generate and
cling to a sense of permanence in self and world that the mind projects onto its
impermanent experience. As our tendencies to cling to illusions of permanence
are illuminated by mindful awareness, we become newly conscious of how
much anxiety and unease our clinging has generated. We can then start to rec-
ognize the same subconscious layers of suffering operating in all others. Thus
sympathy and compassion for self and others emerge with increasing power as
we gain insight into impermanence and the constructed nature of self. Such sym-
pathy and compassion in relation to our selves inform the gentle, accepting qual-
ity of mindful attention, giving our mind permission to open to further insight.
And this, in turn, helps empower an increasingly compassionate and discerning
awareness of others in their conscious and subconscious sufferings. (p. 63)

Makransky argues that awareness of our own attachment leads to self-

compassion. Awareness of the same forces operating in our others—par-
ticularly our clients—leads to compassion for the other. This is one of the
core tenants of Buddhism: real mindfulness is inseparable from compassion
312 Chapter 14

and connection. While Tillich would agree, Sartre and Becker certainly did
not find this connection inevitable or even possible. The Buddhists would
respond that Sartre and Becker did not go far enough; without a formal medi-
tation practice, their deconstruction was limited to an intellectual exercise.
Sartre and Becker would counter with the concept that the Buddhists were
programmed to associate compassion with deprogramming. And Tillich
would have the final word with his definition of faith as inclusive of doubt.
The Buddhists are so serious about their deprogramming that they try
to advance a view of Reality unconditioned by fear and desire. Of course,
unprogrammed reality is reality unshaped and unformed by the Net. In this
book, that is equivalent to the Abyss. In Buddhist terms, it is called “empti-
ness.” In the following quote from Sri Nisargadatta note how he also uses the
metaphor of the net.

The real world is beyond our thoughts and ideas: we see it through the net of our
desires, divided into pleasure and pain, right and wrong, inner and outer. To see
the universe as it is, you must step beyond the net. It is not hard to do so, for the
net is full of holes. (Kornfield, 1993, p. 202)

Nisargadatta’s definition of “net” aligns perfectly with the Nomological Net

concept that is so basic to this book. Right and wrong and inner and outer
support cultural norms whereas pleasure and pain tend to support the stable
existence of the Self. “I want/fear, therefore I am” is the Buddhist equivalent
of Descartes.
But Nisargadatta recommends stepping through the holes in the net to see
things as they are. Stepping through the holes is equivalent to launching into
the Abyss. There is no longer any net to organize the raw material of empti-
ness—nothing to protect us from the sense of undifferentiated chaos.
Before making this step into emptiness, the Buddhists recommend prepa-
ration. Recall that Buber agrees and urged aspirants to become strong in the
conventional world before responding to the call of the Abyss. Jack Korn-
field, noted Buddhist teacher, comments on the famous “be someone” quote:

Jack Engler, the Buddhist teacher and psychologist at Harvard, put it this way:
“You must be somebody before you can be nobody.” By this he means that a
strong and healthy sense of self is needed to withstand the meditative process
of dissolution and come to a deep realization of emptiness. (Kornfield, 1993,
pp. 205–206)

Kornfield goes on to caution that if one enters emptiness or encounters the

Abyss prematurely, it will be experienced as meaninglessness, indifference,
or depression. But if the seeker is prepared then the encounter with the Abyss
will bear fruit.
 The Spiritual Path 313

True emptiness is not empty, but contains all things. The mysterious and preg-
nant void creates and reflects all possibilities. From it arises our individuality,
which can be discovered and developed, although never possessed or fixed.
The self is held in no-self, as the candle flame is held in great emptiness. The
great capacities of love, unique destiny, life, and emptiness intertwine, shining,
reflecting the one true nature of life. (Kornfield, 1993, p. 212)

In sum, the very force which terrifies us, which causes us to cling so tightly to
the Net, is the same force that ultimately sets us free. It is a circular journey
where our jailer morphs into our liberator. The Abyss is all darkness viewed
from one perspective and all light from another. Makransky (2012) provides
a final definition.

To realize the emptiness of the world in this way is to realize that nirvana, the
empty essence of experiences, is undivided from the world of interdependent,
changing appearances in the same way in which space is undivided from all
the forms that it pervades. To realize emptiness thus gives one the freedom to
participate in the world without clinging to it, with unconditional compassion
for all who suffer by clinging and reacting to their own concretized projections
of self and other as self-existent. (p. 69)

How does this play out clinically? Obviously walking the path of wisdom in
whatever specific version one finds appropriate permeates every moment of
therapy with every type of client. But in this chapter, we want to specifically
look at how understanding and practicing a wisdom path literally affects
therapy with clients.
Constructionism leads to the edge of the Abyss; the path of wisdom
requires that we leap into it. The void is empty and terrifying but entering
by the right portal results in the kind of outcomes embodied in the Tolle
quote. The practices prepare one for the leap. Essentially they are practices of
purification and mindfulness. Purification practices such as ethical behaviors
and confronting fear and desire allow one to be “somebody before becom-
ing nobody.” Mindfulness, discernment, and living in constant awareness
of emptiness transform the leap from a destructive and terrifying one to one
that yields peace and harmony. On the one hand, the path is spiritual and
takes place in sacred space; on the other hand, there is a seamless integration
between the path of wisdom and all other forms of transformation starting
with the most basic Apollonian practices. Tara Brach (2012) offers a sum-
mary of the path.

The lucid, open, and kind presence evoked . . . leads to the . . . freedom of
nonidentification and the realization of natural awareness or natural presence.
Nonidentification means that your self-sense is not fused with, or defined by,
314 Chapter 14

any limited set of emotions, sensations, or stories about who you are. This
realization that you are “no-thing”—that there is not a static, solid self—is the
ultimate expression of wisdom and the essence of freedom. Identification keeps
us locked into the “small self,” the self of trance. When identification with the
small self is loosened, when we are no-thing, we begin to intuit and live from
the aliveness, openness, and love that express our natural awareness. As Indian
teacher Nisargadatta Maharaj describes it:
Love says, “I am everything.”
Wisdom says, “I am nothing.”
Between these two my life flows. (pp. 43–44)

The therapist who has understood a wisdom path will find that it is a kind
of super charged cognitive therapy—a therapy that can easily be adapted
to address virtually all client presenting problems. In place of talking about
rational and irrational beliefs, the Buddhist therapist can talk about whether
an experience or a feeling is representative of “big mind” versus “little mind”
and of “soft belly” versus armoring. As an example, in the following vignette,
I work directly with a woman who has just had a positive experience at a
spiritual retreat. However, on her return home she has run into significant
difficulties in her intimate life.

A 38-year-old, Caucasian female who worked as a nurse presented complain-

ing of depression secondary to a recent break up with her boyfriend. They
had only dated for about three months but she reported that they had had a
remarkable connection, with both of them talking about love, marriage, and
permanency after the first few dates. A week before coming in to see me,
he had seemed distant, and two days later he broke up with her because “he
couldn’t imagine marrying her.” He refused to provide any more details and
cut off communication.
Her friends rallied round her and discussed what might have occurred. When
she presented in therapy, she had adopted one of her friend’s theories and was
thinking that he must have been a sociopath to have led her on so fervently and
then drop her so suddenly. She couldn’t stop thinking about him and was crying
so much that it was difficult to go to work.
I began by agreeing with the client that his behavior was unusual and his
pattern of “leading her on and then suddenly dumping her” did suggest that he
was confused in some way or another. She replied with feeling that she was sure
he was a sociopath and had even read several articles about how dangerous this
kind of lover can be to a woman who assumes that people are going to be hon-
est with her. Her affect was moving rapidly between anger at him and complete
personal devastation as she accessed her own inner feelings.
I complimented her on being in touch with her feelings and said that anyone
would be upset with how she had been treated. I further complimented her on
her knowledge of psychopathology and agreed that there are dangerous men out
 The Spiritual Path 315

there that prey on women, men that are often compelled by their psychopathol-
ogy to repeat the same abusive choices again and again.
I then said that I knew she had recently been to a spiritual retreat and
reminded her that she had reported to me that she had gained lots of insight and
inner peace. I asked her to imagine that she was in front of her favorite speaker
from the retreat and had the opportunity to ask the speaker’s opinion about the
relationship with the “sociopath.”
The client looked inward and replied after a minute of consideration, “I think
she would ask me to consider ‘the’ suffering instead of ‘my’ suffering.” She
explained that it had been very helpful to her to consider depersonalizing suf-
fering by holding it in “big mind” as opposed to personalizing everything by
reacting with “small mind.” We discussed big mind in some detail in order to
deepen her connection to the memory.
She regressed back to the retreat and identified an experience of suffering
that she had worked on during that time. I had her relive her retreat work and
specially focused on the lightness she felt as she stayed in “big mind.”
I then asked her to “wrap this consciousness around her” and move to the
memory of being devastated during his breakup talk. I suggested that she allow
the memory to unfold by itself and note how different it would be with this
altered state of consciousness.
The client reported that his breakup still made her sad but that she had an
inner sense of being supported as she re-experienced the discussion. She added
that she had never let in how confused he seemed during the talk and wondered
what kind of disarray and darkness might be affecting his life. She looked
curious, compassionate and much lighter. We discussed some possibilities that
might be affecting him and then went on to discuss healthy grieving.

In this case the client had already completed her preparatory work; she
simply needed to be reminded of what she had already learned. Clearly my
ability to understand what might have been discussed at the retreat and to
work comfortably with that material opened the door to a rapid resolution of
a devastating loss. More importantly, I not only understood what she shared
about her experience at the retreat, she could also feel that I endorsed it as a
“truth.” Working on the spiritual dimension requires the therapist to endorse
the spiritual beliefs of the client as a “fellow traveler.” This is significantly
different than simply understanding the concepts she was expressing.
More important than the client’s improvement, however, is the ability of
the therapist to “feel” the truth that the client had been wounded and trauma-
tized and still give her an option of addressing this painful breakup from a
spiritual perspective. If the client hadn’t been prepared to do this—at least on
an unconscious level—she would have resisted the link between the retreat
and the breakup and required us to dialog further about his pathology and her
vulnerability. The Frank model requires an agreement between therapist and
client about the rationale for the suffering and the nature of the ritual which
316 Chapter 14

purports to heal it. For the client, her readiness to adopt a spiritual frame led
to rapid healing. For the therapist, offering such a frame and witnessing its
success supports the sense of constructed reality as well as the oracular nature
of the Abyss. This kind of witnessing is a key part of dancing with the Abyss.
This case illustrates what may be the most psychologically useful aspect
of the path of wisdom: the ability to resolve painful and conflicted feelings
simply by recognizing that they are constructed, impermanent, and unreal.
As cognitive therapy teaches, feelings arise not from the event but from our
interpretation of the event. Teachings about no self and constructionism are
vastly more powerful than teachings about rational cognitions; the path of
wisdom is CBT plus a 2000-year-old wisdom tradition. One can argue that
the entire philosophical foundation of Buddhism exists to provide a “place to
stand” where the practitioner can practice discernment and nonattachment.
Complementing this powerful technology is Buddhism’s recognition that it
is not adequate in all cases. Psychologists have long been aware of the dangers
of intellectualizing problems without actually resolving them; typically, these
inadequate strategies lead to displacement, affective leakage, and impulse con-
trol problems. In the next case, Jack Kornfield works with a practitioner who
has attempted to control her shadow side via meditation and spiritual discern-
ment. While she has advanced on her path, her work has hit a familiar impasse.

Another student, a young woman, came to practice with a tremendous sense of

insecurity and fear. In the great pain of her own early childhood she had found
peace by withdrawing into silence and daydreams. By being quiet, she had avoided
trouble and conflict with the world around her. On entering spiritual practice she
was greatly relieved. Here was a place that officially sanctioned her silence and
introversion and supported her withdrawal from the world. To her teachers she
initially seemed to be a very fine meditation student, having no difficulty with
the rules and silence, quieting herself easily and speaking of deep insights into
the transient nature of life and how to avoid the dangers of attachment. She came
to retreat after retreat, but at some point it became clear that she was using her
practice to avoid and run away from the world, that her meditation had simply
re-created the fear of her early family life. Her life . . . was limited to certain com-
partments. When this was brought to her attention, she complained bitterly. Didn’t
the Buddha speak of solitude, of sitting under trees in the forest, living a life of
seclusion? Who were we as teachers to recommend anything different?
Her denial was so difficult to break through that she wandered for many
years meditating in different spiritual communities. Only after 10 years, after
her own frustration and dissatisfaction grew strong enough, was she motivated
begin to change her life, to break out of her compartments. (Kornfield, 1993,
pp. 189–190)

This sort of intervention is very common. The spiritual path can be just
as idolatrous—using Tillich’s language—as the path of power, safety, or
 The Spiritual Path 317

money. More importantly, any time a human tries to do something great,

they will run into their own “stuff.” For example, if I try to be an ideal parent
or an ideal romantic partner, whatever unfinished business I have will come
to the surface. Because of this principle, a great deal of time and effort on
the spiritual path is spent focusing on issues that are commonly classified as
“psychological.”
Why was my client able to let her shadow feelings go and Kornfield’s
student was required to face and deal with her underlying issues? Sometimes
the difference is simply the charisma of the therapist; in certain situations the
client gets a “lift” from the therapist’s sense of what is real and is better able
to release what is constructed. In this situation, however, the difference was
primarily due to the disparity between the two women’s foundations; my cli-
ent had learned to “be someone” more effectively than Kornfield’s student.
How can one discern whether the client is intellectualizing versus actually
letting go? When the Dalai Lama stated that compassion and wisdom are two
wings of a bird, seemingly separate but actually identical, he was showing
the way. A person who lets go of shadow material through discernment and
dispassion simultaneously grows in terms of compassion and connection.
Conversely, the intellectualizer has the emotional signature of rigidity, dis-
tance, and subtle defensiveness.
Our third vignette was chosen to illustrate an attempt to make the therapy
process itself into an embodiment of mindfulness, especially the “not know-
ing” aspect of mindfulness. Contemplative Psychotherapy, a version of
Buddhist psychotherapy, pays particular attention to this aspect of therapy;
practitioner Matthew Tomatz (2008) comments:

Garuda exemplifies the wisdom of facing Kali, as well as the reason for
acknowledging impermanence as fundamental to contemplative psychotherapy.
Garuda, representing space, defines therapeutic movement as occurring in a
spacious atmosphere. Habitually, we become so organized around our ego iden-
tities that we fear becoming anything more. . . . In therapy, clients are drawn to
take flight and transform. To reach this goal, one must first enter the space of not
knowing. . . . This is a space of vitality and texture. This space can vibrate so
radically that it shatters the veil of ego and exposes an impressive and terrifying
landscape of opportunity. (pp. 71–72)

Tomatz uses his work with a heroin addict as a representative example of

contemplative psychotherapy. The client, James, was a widower following
his wife’s recent death from cancer. He had a long history of heroin addiction
going back to a gangster lifestyle when younger but twenty years of marriage
had enabled him to be gainfully employed, accumulate material wealth and
be a father to his children. In spite of these successes, he continued to dabble
with heroin. Tomatz reports that they worked on the addiction for a number
318 Chapter 14

of months and James had finally given up using heroin. However, he kept a
secret stash of drugs that he was loathe to discard; in their discussions, James
and Tomatz had labeled this stash “the hook.”

Over a few sessions, we talked about the hook, its meaning and importance. It
became evident that the hook was keeping James from progressing but it was
not clear why. Intellectually he understood its limiting function. James would
dance between the ideas of disposing the heroin versus keeping it for posterity,
“just in case.” After several sessions, James was particularly close to the edge.
I assumed a warrior’s stance and abruptly pushed him: “you could flush it?”
The room stood still. James was stunned. He was no longer looking at the hook.
He was, instead, staring at his life without any hook. For a moment, James was
naked, facing his life without an ego defense. The room was pregnant with
opportunity.
. . . After few seconds of what felt like eternity, James slid down in the chair
and his chest collapsed. Space evaporated. “I can’t give up the hook! . . . I’m
not ready. I can’t face it.” . . . James closed down the vitality of the present pos-
sibilities by permitting a future of stagnant sameness. For that moment, facing
Kali had reified ego, but, nonetheless, a door had been opened. After several
weeks, James announced he had destroyed his stash. He was standing within
the unknown, eyes open to a future of possibility. (Tomatz, 2008, pp. 70–72)

In this example, Tomatz illustrates how to take the experience of mindfulness

meditation and overlay it on therapy. What occurs internally gets reflected
externally. An unquiet, contracted mind focused on ego attachment manifests
its spiritual pathology as a substance abuse problem. The resolution of this
problem requires making the same commitment to no Self and not knowing
that are found along the spiritual path. The terror of living life without an
ego defense—without the limiting but protecting threads of the Nomologi-
cal Net—was initially too much for James. After some weeks, however, the
experience of being naked—of standing at the edge of the Abyss—became
transformative and he discarded his stash.
An Apollonian therapist would, of course, also have advocated for disposal
of the stash. It is standard practice to remove everything drug related from
one’s life when attempting to be sober; in this sense, clients are asked to
renounce friends they partied with, discard drug paraphernalia, and stay away
from trigger environments and events. The result, as expected, is a gradual
increase in commitment to sobriety.
Tomatz asks for the same relinquishment of the hook but the therapeutic
experience is radically different. The passionate style of Tomatz conveys the
sense that he is present at the edge of the Abyss with his client. Tomatz makes
the same recommendation as the Apollonian therapist but in his hands the
decision becomes primal and archetypal—infused with meaning that points
 The Spiritual Path 319

well past simple sobriety. There is the sense that this decision has become a
key moment in James’ evolution; the decision will be definitive and life alter-
ing. The intervention is clearly Dionysian; it implicitly contains the opportu-
nity for profound transformation.
In essence, Tomatz is on fire with spiritual passion and has imbued the
moment and the decision with numinosity. This is a concrete example of
charisma in action. Imagine what kind of altered state is present in both client
and therapist. Everything has become possible; just one courageous decision
is needed to redeem James’ life. Tomatz has succeeded at bringing James to
the edge of the Abyss.
Social constructionism is seen as a philosophy; the path of wisdom, based
on highly similar ideas, is a centuries-old spiritual discipline. Social construc-
tionism offers a model that provides a good fit for data and theories gener-
ated by the social sciences. The path of wisdom has gurus, disciples, sutras,
scriptures, and practices that promise an end to human suffering and provide
the recipe for the good life.
They seem radically different yet it should be clear from the examples and
analyses in this book that they are essentially the same. Social construction-
ism may have roots in Western philosophy and the social sciences but it
appears that asking the same questions has returned more or less the same
answers. This similarity—or perhaps it is better described as, this unity—is
no accident. The perennial philosophy predicts that all serious enquiries into
what is real result in deepening understandings—discernment—of the dialog
between fundamental and constructed reality.
The take away for psychotherapists is that once constructed reality
is fully embraced, the traditional wisdom literature of various cultures
becomes available. The writings may include culturally specific references,
they may be structured more as poetry or other symbolic processes, but
their essential contributions remain. Integrating this body of knowledge
into one’s own practice has the capacity to enhance charisma, particularly
because many spiritual teachers have been aware of the “reading books
doesn’t enhance spiritual development problem” and have developed work
arounds.

THE PATH OF THE HEART

You see many stars in the sky at night, but not when the sun
rises. Can you therefore say that there are no stars in the heavens
during the day? Because you cannot find God in the days of your
ignorance, say not that there is no God.
—Ramakrishna, The Gospel of Sri Ramakrishna (1910)
320 Chapter 14

Even as constructionism points to the path of wisdom, unconditional posi-

tive regard and therapist/client rapport points toward the path of the heart.
Therapy begins with Schore’s right brain-to-right brain connection, and then
moves from the connection to one individual to a connection with all. Buber
urges us to say “thou,” first to one person, then to all persons and finally to
everything. The path of the heart is first a technology to gradually expand the
heart from the one to the many. Ultimately, however, it provides tools that
allow us to hear the universe saying “thou” in response.
This needs to be reemphasized. It is fairly common for Western individu-
als to have an experience of treasuring nature and to develop a commitment
to deep ecology. That is a form of saying “thou” to the natural world. But
the most gifted “connecter,” the “genius individual” in terms of relating to
the universe and all in it, is the one who can hear the universe respond back.
Such individuals have been called prophets, saints, gurus, and teachers. They
get their ultimate authority from what they channel. “I heard this and now I
share it with you.” Of course there are false prophets and caution is appropri-
ate. But the basic decision is subsumed in the question, “Can the universe
respond or is man the only being with a voice?” It was no accident that we
used Buber’s dreams about a “cry” or response to illustrate Tillich’s duality
of faith and doubt.
The path of the heart is as radical and as straightforward as the path of
wisdom. It is radical in that it critiques and displaces common assumptions;
it is straightforward in that love implies connection and connection implies
a two-way dialog. Once deconstructionism and doubt about the nature of the
self are embraced, the path of wisdom forces us to travel to the edge of the
Abyss. The path of the heart is similar. It takes us to a different aspect of the
Abyss, one where we face our own worthiness and our own alienation.
It is more difficult to understand the path of the heart than the path of wis-
dom because most Westerners have been raised in a Judeo-Christian context
of devotion. The path of wisdom seems fresh and new; there are no compari-
sons in common place Western religious experience to a constructionist path
like Buddhism. The wisdom paths of the West tend to be part of the “secret
knowledge.” This is especially true because advocating for constructionism
and formlessness in the context of the Religions of the Book (Judaism, Chris-
tianity, and Islam) could literally get one killed.
Because Western religions emphasize devotion, even the simplest reli-
gious references can give rise to childhood associations that have negative
connotations. For example, many devotional quotes seem like authoritarian
injunctions—commands that must be obeyed regardless of our response. For
some therapists, it is hard to hear something like the following without some
level of bristling.
 The Spiritual Path 321

And he answering said, Thou shalt love the Lord thy God with all thy heart,
and with all thy soul, and with all thy strength, and with all thy mind; and thy
neighbor as thyself. (Luke 10:27)

This is especially true because many Westerners conflate all prayer and
meditation with the patriarchal image of a male God with a long white beard.
Moreover, the concept of a “divine response” to prayer leads to an even
greater sense of discomfort. Most Westerners, particularly therapists with lib-
eral social and political leanings, have memories of fundamentalist Christians
asserting that they have communicated with God and He has told them that
“gays are sinners and women must be subservient.” Clearly, it is generally
easier to be open to the path of wisdom than the path of the heart.
That said, examine the following vignette from Phil Stutz; he and his part-
ner, Barry Michels, wrote The Tools—a “self-improvement” book which has
sold thousands of copies. While some of the tools are primarily psychologi-
cal, others, such as the one below, are overtly spiritual.
Michels was seeing Janet, a recent college graduate, who was present-
ing because she was having problems with her boyfriend. She found herself
unable to leave him even though he was a deadbeat financially, would flirt
with other women, and would leave her for weeks at a time. Instead of being
assertive, she would criticize herself and imagine that he would be good to
her if she was prettier, or smarter, or whatever.
She expected Michels to give her tools to stop the self-criticism and
encourage her to leave him. Instead, Michels told her that they weren’t going
to fight the self-deprecatory comments. Instead, he was going to teach her
something called the Grateful Flow.

The Grateful Flow in Brief

1. Start by silently stating to yourself specific things in your life you’re grateful
for, particularly items you’d normally take for granted. You can also include
bad things that aren’t happening. Go slowly so you really feel the grateful-
ness for each item. Don’t use the same items each time you use the tool. You
should feel a slight strain from having to come up with new ideas.
2. After about thirty seconds, stop thinking and focus on the physical sensation
of gratefulness. You’ll feel it coming directly from your heart. This energy
you are giving out is the Grateful Flow.
3. As this energy emanates from your heart, your chest will soften and open. In
this state you will feel an overwhelming presence approach you, filled with
the power of infinite giving. You’ve made a connection to the Source.
Quickly, she began to develop a relationship with the Source. For the first time
ever, she felt she was living in a universe that supported and valued her. The
more she had this experience, the less accurate the self-criticisms seemed. Once
322 Chapter 14

she’d achieved this, she found the strength to stand up to her boyfriend and
eventually leave him. (Stutz & Michels, 2012, pp. 177–179)

This is an example of a straightforward integration of psychology and devo-

tion. The therapist tells the client to reach out to God and promises an answer.
Along with the answer will come relief from the symptom and much, much
more.
It is easy to interpret the successful outcome in the vignette to factors pre-
viously discussed. Clearly Michels is a charismatic therapist, a key individual
who can change client reality with a word. And the Grateful Flow is a perfect
example of a ritual that explains the dilemma (she couldn’t leave the nega-
tive boyfriend because of lack of self-acceptance) and resolves the dilemma
(Now I can leave the boyfriend because I have been affirmed by the Source).
Michels might argue that his intervention supersedes the charisma/ritual
explanation in that it actually taps into a force that is always ready to respond
if we simply ask for/open to it. The path of the heart frequently leads to this
same dilemma—is the response real or is it programmed? We have already
understood the Tillichian response to this dilemma: a dynamic Faith that is
eternally interwoven with Doubt. The path of the heart essentially exists at the
crux of this basic question: alone or connected, love or self-interest, meaning-
ful or meaningless, spiritual or chaotically empty.
Many spiritual injunctions, such as the one above admonishing us to “love
the Lord thy God with all thy heart,” are essentially instructions for attaining
a particular type of altered state conducive to hearing a divine response. The
instructions show the path to the Abyss and enjoin us to jump.
The path of wisdom starts with deconstructing programming via Neti-neti
(not this, not that) both intellectually and in the altered state of meditation.
Similarly, the path of the heart deconstructs the feeling that we are alone and
lost. This dilemma is embodied in the following Thomas Merton (2002) quote:

The real reason why so few men believe in God is that they have ceased to
believe that even a God can love them. (p. 213)

Wisdom seekers quiet the mind with meditation; devotees quiet the mind
with service. The Dalai Lama says, “My religion is very simple. My reli-
gion is kindness.” Kindness, service, “loving others as our self,” these are
the meditations of the Heart. They prepare the Heart to hear/feel the divine
response just as meditation prepares one for emptiness and ego dissolution.
That said, it can still be difficult for certain Western intellectuals to work
effectively with the path of the heart given that often its symbolism is so con-
crete and so connected to traditional human relationships. For example, in the
quote below, Sri Chinmoy provides the following instructions:
 The Spiritual Path 323

Do not try to approach God with your thinking mind. It may only stimulate your
intellectual ideas, activities, and beliefs. Try to approach God with your crying
heart. It will awaken your soulful, spiritual consciousness. (Chimnoy, 2015,
Kindle Locations 988–990)

This is a challenge. Chinmoy is telling us to discard our intellect and our

rationality—the two elements most identified with modernism—and cultivate
the attitude of a child who is “crying out.” In this quote, he is consciously
rejecting the idea that intellect and rationality are important in terms of the
Heart. He is being intentionally offensive—literally pointing out that the road
is closed to these mental approaches. Such quotes tend to disturb us in that
the mental tools are so often so helpful; simultaneously the quote intrigues
those of us who understand that the tools do not open every door. Examine
the following quote from Way of the Pilgrim that embodies one kind of con-
sciousness achieved by devotees.

The holy Fathers were right when they said that The Philokalia is a key to the
mysteries of holy Scripture. With the help it gave me I began to some extent to
understand the hidden meaning of the Word of God. I began to see the meaning
of such sayings as “the inner secret man of the heart,” “true prayer worships in
the spirit,” “the kingdom is within us,” “the intercession of the Holy Spirit with
groanings that cannot be uttered,” “abide in me,” “give me thy heart,” “to put
on Christ,” “the betrothal of the Spirit to our hearts,” the cry from the depths of
the heart, “Abba, Father,” and so on.
And when with all this in mind I prayed with my heart, everything around
me seemed delightful and marvelous. The trees, the grass, the birds, the earth,
the air, the light seemed to be telling me that they existed for man’s sake, that
they witnessed to the love of God for man, that everything proved the love of
God for man, that all things prayed to God and sang His praise. Thus it was that
I came to understand what The Philokalia calls “the knowledge of the speech of
all creatures,” and I saw the means by which converse could be held with God’s
creatures. (Sand, 1989, p. 28)

This quote illustrates a certain level of consciousness often reported by prac-

titioners who follow the path of the heart. Their devotional practices result in
a pervasive sense of love and connection. In this quote, the pilgrim feels that
everything in the world is simultaneously both a sign of the divine love for man
and a paean of joy arising from all of creation toward God. There is a palpable
sense of connection and belonging. There is an absence of fear and desire and
an ability to be fully present. The perennial philosophy documents this type of
devotional experience across various cultures and historical periods.
One of the biggest obstacles to devotional practice for sophisticated prac-
titioners of modernity is that such practice typically requires relating to what
324 Chapter 14

is called “God with form.” As soon as the divine is conceptualized as “with

form,” a number of incongruences and contradictions arise. Interestingly, one
of the ways to resolve this challenge comes from studying certain psycho-
therapeutic techniques, particularly techniques that focus on visualizations
and dissociation.
To illustrate this point, let us begin by examining a common exercise that
comes from the health psychology literature. In the following example, the
therapist is introducing the client to the concept of how to use imagery to
evoke salivation.

Today I’m going to teach you how to generate a somatic response that is nor-
mally outside of conscious control. First, let me ask you: can you make yourself
salivate via a conscious command? No? Well simply follow my directions and
see what happens.
Please close your eyes, sit comfortably, and take in a few easy breaths. At the
end of the next exhalation, I want you to imagine that you’re in your kitchen and
are looking down on a lemon on a cutting board. Reach out and hold the lemon.
Notice its yellow color but particularly pay attention to that slightly slippery
feeling that lemons have.
Now put it back down on the cutting board and pick up a knife. Carefully cut
the lemon in half and notice the pungent smell released as you cut and feel a
drop of lemon juice on the hand holding the lemon. Now, I want you to pick up
the lemon half and hold it up to your nose and, inhaling, smell that fresh, lemon
scent. Finally I want you to put it in your mouth and bite down on it.
Now, tell me if your mouth is full of saliva.

In this brief example, the therapist shows the client how to use imagery to
create salivation—a somatic response normally outside of conscious control.
This is usually done to motivate the client to use more advanced imagery
techniques to work with a chronic disease like cancer or to address a pain
issue. The therapist typically tells the client that they need to become com-
fortable using symbolic imagery if they wish to affect a somatic process. You
can’t tell your mouth to salivate; you have to imagine biting the lemon. In
essence, the client is asked to imagine something that is not literally true in
order to generate a desired response. Now, let us take this one step further by
looking at the following example of inner child work from my own practice.

A 46-year-old, Caucasian female recently received a promotion at work which

required her to do a substantial amount of public speaking. She explained that
she had enormous anxiety at the prospect of delivering these lectures and was
considering refusing the promotion because she was so afraid. When questioned
about her theory about the source of her anxiety, she mentioned that her mother
had been a “Narcissist” who consistently demeaned and attacked her whenever
 The Spiritual Path 325

she did anything connected to a personal success. In spite of this early training,
the woman had prospered in life due to her intelligence, creativity and diligence.
She was asked to remember the last time she was significantly anxious in
a public speaking setting and to note how that felt in her body. Then she was
asked to follow these feelings back to a memory from long ago. This process
took her to a childhood experience where she was humiliated by her mother in
front of her friend.
She put that memory on hold and spent the next few minutes remembering
three positive experiences which embodied her own highest level of function-
ing; she chose one that was connected with a professional success, one that was
connected with feeling loved, and a final one connected with having a wonderful
time laughing with her friends.
I asked her to briefly describe the memory with her mother and then she was
asked to close her eyes and return to the image. She began by describing the girl
to me: her age, how she was dressed, and especially what her facial expression
revealed about how she was feeling. Her breathing slowed down, she became
still, and seemed very engaged in the experience. I asked her to introduce herself
to the young girl as “her grown-up self from the future returned to help her deal
with her feelings.” She hugged and held the girl and reported that the girl felt a
bit better with her there.
She was asked to take the girl by the hand and lead her to the first of her
three positive experiences. After watching and re-experiencing the first memory
of professional success, the client reported that the girl seemed surprised and
shocked at what she had seen but was also delighted and smiling. Exposing her
to the next two memories further enhanced the young girl’s sense of safety and
happiness.
The client was then asked to “wrap” the young girl with these memories
as if they were a cloak of power or an energetic shield. Then she was asked
to go to the memory of the public speaking anxiety and rewatch the memory.
With this witnessing, however, she would see how that memory would change
when she approached the public speaking “wrapped in the cloak of her positive
memories.”
As the client watched, a small smile appeared on her lips. After the witness-
ing, she reported that she had been able to deliver the speech with comfort and
confidence and that she and the girl were delighted. Finally she gave the girl a
big hug, promised to visit her again soon, and elicited a promise that the girl
would help her stay centered during any further public speaking events.
The client reported feeling very optimistic that she could transfer this experi-
ence to the real world and returned in two weeks saying that her public speaking
experiences were much improved and that her qualms about her new position
were essentially gone.

This example of inner child work builds on the preceding example in that
both require the utilization of a symbolic process. First, just like the example
of the lemon, the symbolic inner child work is required because, without a
326 Chapter 14

symbolic experience, a client can’t remove their anxiety or enhance their

self-esteem through a simple act of will. She needed to use a metaphoric
process—epitomized by an imaginary interaction with a child—to alter her
anxiety.
This leads to the question of whether the experience was “real.” Certainly
there was no lemon present in the saliva example and no one believes that the
client has an actual homunculus within her somewhere. But therapists would
argue that the client needs to act “as if” it is real in order to contact the part of
the psyche required to elicit the desired change. Moreover, therapists believe
that clients who can do this effectively have a certain kind of “talent”—the
ability to make an inner process “real” opens many doors to healing and
understanding that are normally closed.
And then the situation starts getting a bit strange. Therapists who regularly
practice inner child work commonly report that when the client becomes
deeply involved in the experience, the inner figures seem to become autono-
mous—out of the conscious control of the client. The client cannot make the
inner child happy or sad; the inner figure operates independently and appears
to be an actual representation of a certain part of the psyche. The question
of “real” arises again. Have the clients succeeded at directly contacting the
independent, unconscious mind through their exercise or are they simply
posturing to please the therapist?
With the lemon and the saliva, the answer seems clear: since salivation
occurs, there is a “real” connection between the conscious mind and the
salivary glands via the imaginal exercise. Similarly, since the anxiety is
diminished, the inner child exercise must have provided some kind of real
connection to the “unconscious mind.” The client was unable to will saliva-
tion; now, with this imagery approach, they can. They were unable to will
away their anxiety or talk themselves out of it; now, secondary to the interac-
tion with the child, it is significantly diminished. In sum, both the lemon and
the inner child examples, while “unreal” from the external reality/rationalist
point of view, are completely real from both the outcome perspective and
from the pragmatic perspective. And in this sense “pragmatic” implies that
symbolic and imaginal communication is the most practical—and hence, most
real—bridge between the conscious mind and these unconscious processes.
Returning to the path of the heart, recall that the primary aim of the devo-
tee is to make God central in her life. Humans have various experiences of
the sacred; Eliade argues that they are sprinkled throughout human experi-
ence, sometimes predictably and sometimes spontaneously. How does the
devotee build a life centered on such experiences? The lemon and inner child
examples demonstrate that this kind of connection is going to be symbolic
and imaginal. Just as anxiety was portrayed as a “hurt child,” the divine is
going to be portrayed as a father, a mother, a dear friend, or counselor. It is
 The Spiritual Path 327

certainly possible to have a relationship with God without using metaphoric

relationships; the first section of this chapter—the path of wisdom—describes
exactly how to do that. But most people are naturally drawn toward the path
of devotion with its familiar relationships of father, mother, and so on. Is it
easier to eliminate anxiety by metaphorically comforting and supporting a
hurt child or is it easier to reduce the anxiety by affirming it is rooted in a false
sense of self? In the following quote, James Hillman argues that the path of
the heart requires what he calls “personifying.”

Nearer our own times another Mediterranean, the Spaniard Miguel de Unamuno
(b. 1864), returned to the relationship of heart and personified images and
explained the necessary interdependence between love and personifying:
In order to love everything, in order to pity everything, human and extra-
human, living and non-living, you must feel everything within yourself, you
must personalize everything. For everything that it loves, everything that it pit-
ies, love personalizes . . . we only love—that which is like ourselves . . . it is love
itself . . . that reveals these resemblances to us. . . . Love personalizes all that it
loves. Only by personalizing it can we fall in love with an idea.
He sums up, saying: “Our feeling of the world, upon which is based our
understanding of it, is necessarily anthropomorphic and mythopoeic.” Loving
is a way of knowing, and for loving to know, it must personify. Personifying
is thus a way of knowing, especially knowing what is invisible, hidden in the
heart. (Hilmman, 1997, p. 15)

Of course, in therapy, the client is completely aware that the lemon doesn’t
exist in physical reality and that there are no “sub-personalities” roving
around the body. In religious life, that difference has been blurred for the
same reason that it gets blurred in the therapy session: the connection is much
more powerful if the client or devotee becomes deeply engaged in the process
and sincerely operates as if the relationship is real in the physical plane. In the
religious world, priests attempt to “materialize” God with stories of miracles,
incarnations, and healings. In the therapy world, the therapist materializes the
experience by acting as if the child is actually there, soliciting descriptions of
the child’s mood and behavior, and supporting the autonomous actions and
feelings of the child. This “blurring” is key to creating the autonomy of the
object of meditation; when the object begins to generate independent behav-
iors, one knows the connection is real.
Historically, of course, this blurring of the physical world and the spiritual
world has been very confusing. In physical reality, if God is my father—and
he has infinite power—nothing bad should be allowed to happen to me.
Conversely, in the spiritual world, acting as if God is my father enables
me to have a powerful connection, a connection so powerful it can lead to
actual dialog. Without this personified connection, the possibility of dialog
328 Chapter 14

is closed to me. So if a rationalist points out that my stance toward God the
Father has implicit incongruities—nothing bad should happen to me if this is
a real relationship—I will look at the rationalist with pity and say, “Try it and
perhaps you will be able to understand.” The rationalist leaves, confident that
the incongruity has destroyed the validity of my experience. And in so doing,
misses that the principle of personification is aimed at achieving connection
through an altered state, not removing cognitive inconsistencies. In the fol-
lowing quote, Swami Vivekananda looks at this real versus unreal question
from a more spiritual perspective.

If a man can realize his divine nature with the help of an image, would it be right
to call that a sin? Nor, even when he has passed that stage, should he call it an
error. . . . Man is not traveling from error to truth, but from truth to truth, from
lower to higher truth. To him all the religions from the lowest fetishism to the
highest absolutism, mean so many attempts of the human soul to grasp and real-
ize the Infinite, each determined by the conditions of its birth and association,
and each of these marks a stage of progress; and every soul is a young eagle
soaring higher and higher, gathering more and more strength till it reaches the
Glorious Sun. (Vivekananda, 2015b)

Certainly, there are multiple meanings to this quote. In the context of our psy-
chotherapeutic examples—where the autonomy of the inner child is created
by acting as if the child is real all the while knowing it is not—Vivekananda
is describing a hierarchy of consciousness. This kind of consciousness—see-
ing the devotional experience as both real and unreal—is much more natural
in the East with its paradoxical embrace of the concept of God with form and
God without Form.
Buddhism and Hinduism differ from the major Western religions in many
ways but the one most relevant to this discussion is that they have an overt
commitment to constructionism. As an example, examine the most well-
known Taoist quotation.

The Tao that can be told is not the eternal Tao.

The name that can be named is not the eternal name.
The nameless is the beginning of heaven and earth.
The named is the mother of ten thousand things.
Ever desireless, one can see the mystery.
Ever desiring, one can see the manifestations.
These two spring from the same source but differ in name;
this appears as darkness.
Darkness within darkness.
The gate to all mystery. (Lao Tzu, Tao Te Ching, p. 80)
 The Spiritual Path 329

Virtually every line of this quotation is constructionist. It is explicitly

designed to contrast the Abyss and the Net and move the reader from one
perspective to another. It demonstrates Eastern religion’s readiness and abil-
ity to deconstruct the literalness and the programming implicit in so many
religious practices. Yet, with all that ability to take things apart, Eastern
religions continue to recommend and support the path of devotion for the
same reason that therapists like inner child work: the simplest and most direct
relationship with God occurs through mimicking familiar social relationships.
Ramakrishna states:

The rishis of old attained the Knowledge of Brahman. One cannot have this so
long as there is the slightest trace of worldliness. How hard the rishis labored!
Early in the morning they would go away from the hermitage, and would spend
the whole day in solitude, meditating on Brahman. At night they would return
to the hermitage and eat a little fruit or roots. They kept their minds aloof from
the objects of sight, hearing, touch, and other things of a worldly nature. Only
thus did they realize Brahman as their own inner consciousness.
But in the Kaliyuga, man, being totally dependent on food for life, cannot
altogether shake off the idea that he is the body. . . . When a man does all sorts
of worldly things, he should not say, “I am Brahman.” Those who cannot give
up attachment to worldly things, and who find no means to shake off the feeling
of “I,” should rather cherish the idea, “I am God’s servant; I am His devotee.”
One can also realize God by following the path of devotion.
. . . The path of knowledge leads to Truth, as does the path that combines
knowledge and love. The path of love, too, leads to this goal. The way of love
is as true as the way of knowledge. All paths ultimately lead to the same Truth.
But as long as God keeps the feeling of ego in us, it is easier to follow the path
of love. (as cited in Nikhilananda, 1984, p. 132)

And further.

If you desire to be pure, have firm faith, and slowly go on with your devotional
practices without wasting your energy in useless scriptural discussions and
arguments. Your little brain will otherwise be muddled. (as cited in Abhedan-
anda, 2010, p. 75)

Eastern religions have little trouble integrating the devotees and the wisdom
seekers; they can move effortlessly from one perspective to another. With
all their commitment to devotion, they are prepared to acknowledge that
God with form is always God with inconsistencies and incongruences. Yet,
being constructionists, they do not find these inconsistencies off putting;
rather, they see them as part of the nature of constructed reality. In addition,
they join with Hillman and the psychotherapeutic world in recommending
330 Chapter 14

personification; yes, it comes with incongruences but God with form is much
more approachable for most humans.
Now, let us proceed to a brief summary of the path of the heart. In so many
ways, the path of love is the simplest thing to describe: love God with all your
heart and soul. Orient your life around this love. Feel His Presence constantly.
Dedicate your life to serving God. Strive to imitate God as much as possible.
Pray to open your heart to His Voice and to follow His Will.
This is not an affectation or an attitude but a firm decision—a complete
commitment—a new pole star for one’s life.

We should fix ourselves firmly in the presence of God by conversing all the time
with Him . . . we should feed our soul with a lofty conception of God and from
that derive great joy in being his. We should put life in our faith. We should give
ourselves utterly to God in pure abandonment, in temporal and spiritual matters
alike, and find contentment in the doing of His will, whether he takes us through
sufferings or consolations. (Lawrence & Beaufort, 2010, p. 5)

And, while this level of dedication can sound daunting, in actuality God
places light demands on us.

He does not ask much of us, merely a thought of Him from time to time, a little
act of adoration, sometimes to ask for His grace, sometimes to offer Him your
sufferings, at other times to thank Him for the graces, past and present, He has
bestowed on you, in the midst of your troubles to take solace in Him as often
as you can. Lift up your heart to Him during your meals and in company; the
least little remembrance will always be the most pleasing to Him. One need not
cry out very loudly; He is nearer to us than we think. (Lawrence & Beaufort,
2010, p. 24)

And, if you reach out to God in this manner, you will receive a response.

Through selfless work, love of God grows in the heart. Then through his grace
one realize him in course of time. God can be seen. One can talk to him as I am
talking to you. (Ramakrishna, as cited in Nikhilananda, 1984, p. 109)

Living at this level of consciousness means that everything in one’s life is

pervaded by the divine. Everything that occurs, every person one meets, is an
encounter designed and orchestrated by God. In that sense, everything that
happens is a lesson sent specifically to you from God. If it is painful, it is sim-
ply “grist for the mill” to use the well-known Ram Das term. If it is a chance
meeting with a person or event, it is a personal message from the divine. The
Baal Shem Tov describes it as follows:
 The Spiritual Path 331

Everything is by Divine Providence. If a leaf is turned over by a breeze, it is only

because this has been specifically ordained by G–d to serve a particular function
within the purpose of creation. (Baal Shem Tov, as cited in Kahn, 2016, The
Search for Meaning)

And what is promised to a person who chooses to live life this way: inner
peace, self-awareness, and the bliss and joy of being united with the Lord.

Cleaving to G–d is the master-key that opens all locks. Every Jew, including the
most simple, possesses the ability to cleave to the words of Torah and prayer,
thereby achieving the highest degrees of unity with G–d. (Buber, 1995, p. 23)

This consciousness is a kind of craziness when measured by the rules of

the world—a divine madness that leads to the fulfillment of human destiny.
Ramakrishna tells us:

If you must be mad, be it not for the things of the world. Be mad with the love
of God.

Lest this simplicity seem easy, Swami Vivekananda adds a cautionary note.

The one great advantage of Bhakti (the path of devotion and love) is that it is
the easiest and most natural way to reach the great divine end in view; it’s great
disadvantage is that in its lower forms it oftentimes degenerates into hideous
fanaticism. The fanatical crew in Hinduism, Mohammedanism, or Christianity,
have always been almost exclusively recruited from these worshippers [sic] on
the lower planes of Bhakti. That singleness of attachment (Nishthâ) to a loved
object, without which no genuine love can grow, is very often also the cause
of the denunciation of everything else. All the weak and undeveloped minds in
every religion or country have only one way of loving their own ideal, i.e., by
hating every other ideal. Herein is the explanation of why the same man who
is so lovingly attached to his own ideal of God, so devoted to his own ideal of
religion, becomes a howling fanatic as soon as he sees or hears anything of any
other ideal. (Vivekananda, 1964, p. 35)

The path of devotion is easy to describe although, of course, it is difficult

to live. Making God central in one’s life requires a level of egolessness and
commitment that are challenging to sustain in the real world. That said, it is
the implicit extension of all that is essential in the therapeutic relationship:
unconditional positive regard, compassion, and connection. Feeling con-
nected to all others in love and service is admirable; it is a meaningful step on
the path. Feeling some kind of real response from the divine—as experienced
by the client with the Grateful Flow—is another step altogether.
332 Chapter 14

Putting this into practice requires the ability to speak directly to the spiri-
tual identity of clients, to be comfortable using religious language, and to be
able to access one’s own spiritual feelings. The following example, which is
from my own practice, focuses on what may be the most common application
of spirituality to psychopathology—laying one’s worries and anxieties at the
feet of the Lord.
A fifty-five-year-old nurse presented complaining that she was experienc-
ing so much anxiety about her adult son that she could barely sleep. It seems
that her twenty-three-year-old son had problems with alcohol, depression, and
violence. He would try and be sober, but whenever he had some life stress,
he would return to the bottle. After drinking a certain amount, he would go to
the local bar and seek out fights with the other patrons. Following the fight, he
would wake up with a hangover, a set of bruises, and horrible self-recrimination
about his behaviors. His self-deprecation was so strong that he frequently had
suicidal thoughts. The depression and self-hatred would lead to a resolve not to
drink; the depression would eventually lift; the life stresses would return; and
the cycle would repeat. The mother had an ongoing feeling that he was about
to die, either in a fight, by his own hand, or secondary to his alcohol abuse.
The client reported that her spiritual life was very important to her and,
although she only attended church once or twice a month, she had an active
prayer life and felt she had a personal relationship with God. I asked her if
she used the image of the “Sacred Heart” in her prayer practice and she said
that she did. I suggested that she offer up her anxiety and helplessness about
her son to the “Sacred Heart.”

You might want to make a small altar somewhere in your house or your bed-
room. On the altar you can have a candle, a picture of your son, and any other
spiritual symbols that appeal to you. Every morning and every evening sit in
front of the altar and light the candle. Say any prayer that appeals to you to
invoke the presence of God. Many people use the Lord’s Prayer or the Jesus
Prayer or the Prayer of St. Francis, but use the one that feels best to you—that
most easily gives you the sense of presence. After the lighting of the candle
and the invocation, just sit quietly and begin to pray for your son. Again your
prayers can take and shape and form that feels right to you but make sure that
at least partially you pray to be relieved of the idea that you are still responsible
for your son’s welfare. Project the understanding that you know that his fate is
in God’s hands—not yours—and be asked to be relieved of the sin of Pride and
Power. You know that you have no power over your son’s fate and your feel-
ing that you do have responsibility is a form of spiritual confusion. Offer that
confusion to the Sacred Heart.
After a while, if you pray sincerely, you will begin to feel a sense of an
answer or response. This may take the form of Grace or inner Peace, or some-
thing like that. Sincere prayers will evoke a response. . . . No one can say exactly
 The Spiritual Path 333

the form of this response. Most likely it will relieve you of your anxiety. It’s also
possible that the response may lead you to something else you need to learn, or
let go of, or respond to.
Continue this twice daily prayer practice until you see me again in 10 days.

On her next visit, the client reported that her anxiety was markedly reduced.
She also said that she had felt a response that felt like a flood of inner peace—
which she termed “grace.” Finally, she had had an insight that she needed to
discuss something with her husband, the son’s stepfather, about certain com-
ments he made about the son. She had asked him to refrain from being critical
about the son’s poor choices as such comments only served to agitate her. He
was open to the feedback and promised to change the nature of his comments.
This vignette not only offers an example of how quickly a client can
respond using a devotional approach, but it also has implications about life
lessons and personal deepening. The client’s symptom—anxiety—led her
into an enhanced sense of her connection to God. More importantly, she had
an experience where God reached back to her both with guidance and with a
sense of grace and inner peace.
This question of “reaching back” is central for the path of devotion. It is
one thing to discuss attempting to become a manifestation of love and accep-
tance but it is quite another to realize that all of us are profoundly limited
in terms of that giving by our own fear and confusion. The path of devotion
resolves this by repeatedly putting God or a higher power on center stage and
then attempting to channel that level of love and acceptance.
This experience of love and acceptance coming through me is a common
one for most therapists. There are endless stories that go something like this:
“During the session I felt the pain and loneliness of the client and my heart
opened. Then it felt like something outside me—larger than me—was com-
ing through. My heart felt bigger and warmer and the client started respond-
ing differently, like they weren’t afraid anymore. Afterward, when we both
talked about it, we both agreed that it was a kind of magical experience.”
It hardly matters whether one takes this as a construction, a documented
experience of the presence of a higher power, or a form of right brain-to-right
brain connection; given that such experiences are relatively common, they
serve to document the human ability to manifest love and connection. And
the sense that something comes through from the outside—that there is a
“response” as Buber puts it—is a central feature. And, of course, it is a small
step from channeling a higher power for another to prayer and the attempt to
feel a personal response.
The following vignette highlights a different angle on the path of the heart.
In this case, I take an Apollonian stance and challenge the client to choose
behaviors consistent with her spiritual beliefs.
334 Chapter 14

A woman in her late 40s presented, complaining of anxiety, fatigue and resent-
ment. She was married, had 3 children, and worked as a midlevel executive.
Her husband suffered from a variety of anxiety disorders including panic attacks
and agoraphobia. His anxieties were so numerous and pervasive that they had
come to dominate the family in that his level of discomfort ruled out so many
family activities. He had been underemployed for a decade and was only able to
work part time at a low stress, low pay job. He was adamantly against getting
medication or therapy for his condition. After urging him to get some help—and
getting a “no” in response—the wife had essentially accepted that he was never
going to work on it. The parents were serious Christians and went to church
diligently each week.
The wife reported that she was exhausted because she felt that virtually all
the care of the children fell on her; it seemed that the husband was not only
anxious, he somehow lacked the common sense and ability to connect required
for parenthood. She was resentful because she felt she was doing all the work,
providing almost all the money, and her husband was constantly pressuring her
to make love more often. When asked whether she had thoughts of divorce,
she answered immediately and clearly that she felt her vows were sacred, made
before God, and that she would never break them. When asked about confront-
ing her husband and asking him to get psychological help or get a better job, she
replied that she was convinced that he was disabled because of a bad childhood
and, even though he was a good person at core, he was unable to perform at a
higher level.
She came in for a session noting that the children were going to visit their aunt
the following weekend and she was dreading the incessant pressure to have sex
that she expected from her husband. In response I told her that I respected her
marriage as a sacred union but that she was taking the commitment too lightly.
“In a sacred marriage the vow is not simply to stay married but to view your
role as a wife as an opportunity to serve God. Of course your husband is a man,
but if you serve him as you would serve Jesus you will be blessed and you will
have a sacred marriage. Making love is at the center of any marriage and your
resistance to making love with your husband is an abandonment of a spiritual
opportunity. Of course you resent him with your human side for giving in to his
anxiety, not carrying his share of the load, and not getting help but it is impor-
tant to put those things aside for this weekend and celebrate the sacred union.
You have also been derelict in your marital responsibilities in that you have
allowed him to conduct himself in such a way that he has lost self-respect and
the respect of you and the children. The marital vow includes vows about taking
care of each other when ill. It is not taking care of him to allow him to continue
on a course that makes him worse and results in poor relationships.
You need to begin by making love to him not as the man who has faults but
as the man that was chosen for you by God. Then you need to step up and take
care of him the way you would care for the divine child.”
The client returned the following week reporting that the love making week-
end had gone well and actually been pleasurable and connecting for her. During
 The Spiritual Path 335

the session, she committed to confronting him about the burden of his anxiety
on him, her, and the family. Following that confrontation, he agreed to enter
individual therapy.

The important part of this intervention was my willingness to operate inside

the dimension of Apollonian power. Every spiritual path has its own rules
and guidelines that define the good life. By and large such rules, interpreted
thoughtfully, are, in fact, helpful for the practitioners. Stepping into the role
of religious authority is functionally identical to Glasser’s recommendation
that therapists make use of ideas like right and wrong and healthy/unhealthy.
When such ideas are presented with sensitivity, they can be a great motivator
for the client.
For the therapist, the opportunity to serve as a spokesperson for spiritual
authority requires a high level of engagement with the relevant spiritual prin-
ciples. This was both a challenging situation for me in that urging a woman
to have sex with a husband she disrespects seems counter to supporting her
ultimate concern. On the other hand, she had defined the rules she was play-
ing by, and from that perspective, she had already committed both to make
her husband happy sexually as well as confront him when he was lost. She
created the exterior of the ritual when she reported that her Christian Faith
was the center of her marriage; I merely filled in the details of the ritual.
I did suspect that my requirement that she be a “good wife” would lead to
her feeling empowered to require him to be a “good husband.” Obviously I
laid the groundwork for this with my comments about “stepping up.” What
overtly appeared to be a request for her to practice “Christian submission”
was paradoxically a request for Christian assertion and leadership.
In terms of my own growth, I had to understand the unity of psychological
and spiritual principles. I needed to feel the constructed nature of the ritual.
I also had to experience the sense of power that flows when one embraces
right/wrong with integrity. Finally, I needed to feel the essential alignment
with her ultimate concern that actually gave the ritual healing power. To me,
this required dancing with the Abyss.

SPIRITUAL MATERIALISM

Do not believe a thing because you have read about it in a book. Do

not believe a thing because another man has said it was true. Do not
believe in words because they are hallowed by tradition. Find out the
truth for yourself. Reason it out. That is realization.
—Swami Vivekananda, The Complete Works
of Swami Vivekananda (1907)
336 Chapter 14

The influx of Eastern teachings in the 1970s opened a vast range of spiritual
possibilities to hungry Western seekers. Not surprisingly, the Westerners
approached the eastern ideas from the context of their own culture; while
this approach occasionally created a kind of symbiotic positive effect, in the
main it diluted and altered the Eastern teachings in an unhelpful and inap-
propriate manner. This effect was so striking that one of the Eastern teachers,
Chogyam Trungpa, wrote an entire book, Cutting Through Spiritual Materi-
alism (2002), focusing on the ways Westerners attempt to achieve spiritual
progress using methodologies and strategies oriented toward winning a prize
or accomplishing a material goal. In the following quote, he emphasizes how
difficult it can be to discern between genuine spiritual practice and enhance-
ment of the ego.

Walking the spiritual path properly is a very subtle process; it is not something
to jump into naively. There are numerous sidetracks which lead to a distorted,
ego-centered version of spirituality; we can deceive ourselves into thinking we
are developing spiritually when instead we are strengthening our egocentricity
through spiritual techniques. This fundamental distortion may be referred to as
spiritual materialism. (p. 3)

Put in the language of this book, Trungpa is cautioning seekers not to treat
the spiritual path like it operates in fundamental reality but, instead, recognize
that it operates in constructed reality. It is so easy to superimpose fundamen-
tal ideas, assumptions, and practices into constructed space. If we operate like
this, there will be an impressive show of practice, insight, and accomplish-
ment but since the path “is a very subtle process,” we will miss the main
point. Since that has been the fundamental error of Western psychology—and
that error has resulted in no measurable progress for almost a century—it
should be easy for us to take Trungpa’s warning seriously.
Western culture, of course, is the home turf for modernism, science, and
rationality. This makes us particularly at risk in terms of confusing the con-
structed and the fundamental; moreover, it also makes us prone to reification
and black and white thinking. James Hillman, who is well known for his
scathing analyses of simplistic psychological practices, has a special critique
of Westerners attempting to cultivate Eastern spirituality. He cautions West-
erners against practicing an Eastern approach outside of a supportive cultural
context.

Another form of transcendental denial occurs in (westernized) Oriental solu-

tions to psychopathology. . . . My characterization of the Oriental denial of
pathologizing is Western, reflecting the way it is used by Westerners. For what
we do with Oriental transcendent methods derives as much from the Western
 The Spiritual Path 337

psyche as it does from the Eastern spirit. In the East this spirit is rooted in the
thick yellow loam of richly mythologized imagery—demons, monsters, gro-
tesque goddesses, tortures, and obscenities. It arises within mythologized world
of want and despair, chained by obligations, agonized. But once uprooted and
imported to the West it arrives deprived it of its dimensional ground, dirt free
and smelling of sandalwood, another upward vision that offers a way to bypass
our Western psychopathologies. The archetypal content of Eastern doctrines as
experienced through the archetypal structures of the Western psyche becomes a
major and systematic denial of pathologizing. (Hillman, 1997, pp. 66–67)

Hillman is arguing that Eastern thought is grounded when it is practiced in

the East but becomes denial, simplistic thinking, and a rationalizing, New
Age pap unless we are careful. He particularly warns against the rejection of
shadow that can easily occur when Eastern practices are taken out of context.
Kornfield’s student, and her unwillingness to work with her own psychologi-
cal material, is an example of this kind of mistake. If one takes Hillman seri-
ously, and recognizes that Eastern thought has always been grounded in a part
of the world where profound suffering is experienced on a regular basis, then
it is easy to accept his admonition that Eastern wisdom can lead to escape and
denial unless that level of suffering is somehow factored in.
A second cultural difference is the way in which the numinous is handled
by the different cultures. In the West, the numinous is separated from the
human; we have sinners and saints, the pure and the impure. In the East, the
numinous can manifest in an imperfect vessel. Put more specifically, Eastern
saints can be full of flaws and still point toward the divine. In the West, the
pope is “infallible.” The East sustains respect for its gurus without requiring
infallibility.
As a concrete example, take the case of Ramakrishna Paramahamsa. Imag-
ine that you are visiting India in the middle of the nineteenth century and you
hear about an Indian “saint” named Ramakrishna who is reputed to be a great
devotee of the Holy Mother—a man who has achieved the highest level of
God consciousness. Following is a quote from an Indian man who actually
visited Ramakrishna at his home in Dakshineswar during that period.

When the meeting broke up, the devotees sauntered in the temple garden. M.
went in the direction of the Panchavati. It was about five o’clock in the after-
noon. After a while he returned to the Master’s room. There, on the small north
verandah, he witnessed an amazing sight.
Sri Ramakrishna was standing still, surrounded by a few devotees, and
Narendra was singing. M. had never heard anyone except the Master sing so
sweetly. When he looked at Sri Ramakrishna he was struck with wonder; for the
Master stood motionless, with eyes transfixed. He seemed not even to breathe.
A devotee told M. that the Master was in samadhi. M. had never before seen or
338 Chapter 14

heard of such a thing. Silent with wonder, he thought: “Is it possible for a man
to be so oblivious of the outer world in the consciousness of God? How deep
his faith and devotion must be to bring about such a state!”
. . . The song drew to a close. Narendra sang the last lines:
Caught in the spell of His love’s ecstasy,
Immerse yourself for evermore, O mind,
In Him who is Pure Knowledge and Pure Bliss.
The sight of the samadhi, and the divine bliss he had witnessed, left an indelible
impression on M.’s mind. (Nikhilananda, 1984, p. 142)

Most people—especially most Westerners—lack categories in their mind to

organize such experiences. The simplest response is denial; Ramakrishna
is simulating or faking these experiences in order to achieve something.
Next simplest is concrete belief; Ramakrishna is a living embodiment of
the divine—a perfected being who has achieved God realization. As Eliade
pointed out in the previous chapter, human beings are archetypally prepared
to respond to sacred space by attributing divine qualities to its inhabitants.
If Ramakrishna has achieved Samadhi, then he must be a perfected being.
There are “normal” human beings and there are holy men—humans who
have “attained enlightenment” and are now embodied representatives of the
Divine.
Not surprisingly, seeing teachers, gurus, and lamas as literal incarnations
of the Divine generates the same kinds of problems and issues as a concrete
belief in God, the father. For example, if these teachers can heal some people,
and they are embodiments of compassion, why not heal all petitioners? If they
are really liberated, why do they have so many flaws? For example, Ramak-
rishna frequently preferred the company of certain disciples over others; in
addition, he could become dependent, childlike and require reassurance. And,
while he honored a female manifestation of God, his disciples were almost
exclusively male and he frequently said that “woman and gold” were the
major impediments to enlightenment.
Ramakrishna could have all these flaws and still function as a symbol of
the divine because the East is culturally prepared to support the coexistence
of flaws and divine teachings. Try pulling that off in the West; for example,
in the case of Ramakrishna he might be seen as a hypocritical charlatan. The
Western view is prone to over idealizing or to throwing the baby out with the
bath water.
Why is this important? Because this kind of literalism characterizes many
Western discussions about questions such as “do you believe in God?” and
“is God omnipotent?” The imposition of fundamental reality-type analysis
into constructed reality will always do significant damage to our ability to
understand the process that is actually unfolding.
 The Spiritual Path 339

Returning to the question of the lemon and the inner child, it is clear that
neither of these objects exists in fundamental reality but that acting as if they
exist gives them life, power, and independence. Moreover, unless one invests
these unreal objects with life, their capacity for transformation and healing
will go unfulfilled. Simultaneously, if we believe that the object we have
invested with life now lives in fundamental reality, we will get into all sorts
of problems. Joseph Campbell comments:

Every religion is true one way or another. It is true when understood metaphori-
cally. But when it gets stuck in its own metaphors, interpreting them as facts,
then you are in trouble. (1998, p. 67)

Religious symbols—whether teachers, gurus, or stories of saints and found-

ers—become vital by investing them with meaning and by acting as if they
are real. If we stop there, we will suffer from spiritual materialism. But if we
continue and paradoxically affirm their essential unreality—their symbolic
truth—then we have a chance to avoid the materialism. We act as if the inner
child is real and autonomous but simultaneously know there is no internal
homunculus.
Finally, the concept of spiritual materialism has much to say about the
power and independence of spiritual techniques. In spirituality, it appears—
just as in psychology—that progress is dependent on practicing powerful
techniques. Devotees are urged to meditate, pray, do selfless service, attend
lecture, participate in extended retreats, and so on. These practices are gener-
ally good for people and the practitioners get better and improve as a result
of their efforts. While these improvements are well received, they are not the
essence of the spiritual path. Thinking progress is due to techniques is another
form of spiritual materialism. Examine the critique in the following teaching
story attributed to Dogen Zenji:

When asked why he practiced zen, the student said, “Because I intend to become
a Buddha.”
His teacher picked up a brick and started polishing it. The student asked
“What are you doing?” The teacher replied, “I am trying to make a mirror.”
“How can you make a mirror by polishing a brick?”
“How can you become Buddha by doing zazen? If you understand sitting
Zen, you will know that Zen is not about sitting or lying down. If you want to
learn sitting Buddha, know that sitting Buddha is without any fixed form. Do not
use discrimination in the non-abiding dharma. If you practice sitting as Buddha,
you must kill Buddha. If you are attached to the sitting form, you are not yet
mastering the essential principle.”
The student heard this admonition and felt as if he had tasted sweet
nectar.
340 Chapter 14

Here we have a Zen master critiquing the usefulness of meditation and

telling the disciple that as long as he “believes in zazen” his progress will
be severely limited. Then he gives the admonition to “kill Buddha,” a phrase
that is repeated regularly in the Buddhist teaching tradition. Killing Buddha
is equivalent to beginner’s mind. It is equivalent to the recognition that we
are operating in constructed reality and the feeling that we are in fundamental
reality will continue to creep in. To repeat, the confusion between these two
is the essence of spiritual materialism.
This “kill-the-Buddha” idea is so central to spiritual practice that one finds
it in virtually every spiritual tradition. For example, examine the following
Sufi story:

When Yasavi started to teach, he was soon surrounded by potential disciples

and people of all descriptions. They all listened to what he had to say, but they
insisted more and more loudly on him enrolling them in a regular teaching
curriculum.
Yasavi told them that he wanted them to build a special structure, a Tekkia,
in which people could carry out exercises similar to those which were found
throughout Turkestan.
Several hundred people worked, under his direction, for six months, making
this edifice.
When it was complete, Yasavi said: “All who want to enter this building for
instruction please stand to the right, over there; and those who do not want to
do so, stand over there, to the left.”
Where they were arranged in the two groups, Yasavi said: “I dismiss all
those who stand to the right; there is nothing I can do for you; therefore return
whence you came.
The remainder may become my students. Their first task is to demolish the
Tekkia.”
The dismissed students became disaffected, and spread tales to the effect that
Yasavi was insane. But it is from the selectivity of this madman of God that the
Teaching of the Masters is derived. (Shah, 2016, p. 40)

Once again we see the primary teaching; when the learner becomes attached
to the form of learning, they will miss the essence—they will materialize
spirituality. Like the last story, the teacher emphasizes that believing in tech-
niques is a basic error. And getting attached to techniques—building a Tek-
kia—will result in missing the point so profoundly that the affected disciples
must “be dismissed.”
Psychology has an interesting parallel to these two stories with the research
finding that therapists who are in therapy do not achieve improved outcomes
with their own clients. On the one hand, this makes little sense. We know
that therapy works for the vast majority of clients and, therefore, we can be
 The Spiritual Path 341

confident that the therapist-clients are better than they were before therapy.
Unfortunately it does not appear that this improvement correlates with
enhanced charisma.
This conundrum is explained by our two “kill-the-Buddha” stories. The
therapy is Apollonian; the therapists become better but not different. They
continue to dwell in the Tekkia and enhancing charisma requires demolishing
the Tekkia. Thinking we are trying to get better is spiritual materialism or,
in this case, psychological materialism. Better is an improvement inside the
Net. Different is a change outside the Net. Psychologists wishing to enhance
charisma need to be different, not better.
The “kill-the-Buddha” story cautions the disciples in terms of attachment
to meditation; the Tekkia parable cautions against an attachment to teachings;
the therapy outcome research results require us to give up belief in the innate
power of psychotherapy techniques. Spiritual materialism is equivalent to
psychological materialism. Discern between the constructed and the funda-
mental. Work on being different not better.
It is fitting that we conclude this section with a quote from Jiddu Krish-
namurti. Krishnamurti was an Eastern thinker particularly renowned for his
work with spiritual materialism. In quote after quote, book after book, he
repeatedly emphasizes the need to avoid the easy approach of a path defined
by form, concrete structure, and techniques. Instead he emphasizes con-
sciousness, courage, and self-awareness.

There is no method of self-knowledge. Seeking a method invariably implies the

desire to attain some result—and that is what we all want. We follow author-
ity—if not that of a person, then of a system, of an ideology—because we want
a result that will be satisfactory, which will give us security. We really do not
want to understand ourselves, our impulses and reactions, the whole process of
our thinking, the conscious as well as the unconscious; we would rather pursue
a system that assures us of a result. But the pursuit of a system is invariably the
outcome of our desire for security, for certainty, and the result is obviously not
the understanding of oneself. When we follow a method, we must have authori-
ties—the teacher, the guru, the savior, the Master—who will guarantee us what
we desire, and surely that is not the way of self-knowledge. Authority prevents
the understanding of oneself, does it not? Under the shelter of an authority, a
guide, you may have temporarily a sense of security, a sense of well-being, but
that is not the understanding of the total process of oneself. Authority in its very
nature prevents the full awareness of oneself and therefore ultimately destroys
freedom; in freedom alone can there be creativeness. There can be creativeness
only through self-knowledge. (Krishnamurti, 1995, p. 95)
 Chapter 15

Becoming Remarkable

Become who you are!

—Friedrich Nietzsche, Ecce Homo (1908)

This book has advanced the concept of key individuals—individuals who

are given the power to determine what is real and what is not real. Such
individuals can be identified by their “charisma”—a numinous quality which
requires us to defer to their guidance and ideas. In psychotherapy, of course,
the Reality B therapist is not trying to hide his charisma; in fact, he has no
more important priority than to be recognized as a charismatic healer by his
clients. A therapist does not want to be like Elijah, often disguised as a poor
traveler, who passes through the world recognized by the few. Instead, the
first task in the first session of therapy is to communicate to the client that the
therapist is a charismatic person who has the power to alter identity and real-
ity. In this sense, Glasser noted that success in reality Therapy depended on it
being conducted by a “responsible” person who has achieved a certain level
of success in life and is recognized as such by the client. And Scott Miller
finds that most therapeutic change can be predicted by the response of the
client to the therapist in the first three sessions. In fact, unless change occurs
that quickly, Miller often recommends a referral to another therapist. The cli-
ent quickly recognizes the therapist as someone who either has the power to
help him change or as someone who doesn’t.
Usually, this revelation of charisma is described as “instilling hope” or
“positive expectations” in the client. While occasionally this hope is due
to some information that the therapist imparts, more frequently hope rises
because the client becomes convinced that the therapist has the ability to help
her with her presenting problem. Often it appears as if the hope is instilled
by a correct diagnosis and the prescription of the right techniques—“you’re
343
344 Chapter 15

depressed and we’ll be using cognitive therapy to reduce the depression”—

but in reality the hope engendered by those words varies wildly depending
on which therapist speaks them and all the nonverbals that accompany the
enunciation. Examine the following quote from Milton Erickson:

And he didn’t think it was at all necessary to tell me that he had passed the
law examination. Because my attitude towards patients is: You are going to
accomplish your purpose, your goal. And I am very confident. I look confident.
I act confident. I speak in a confident way, and my patient tends to believe me.
And too many therapists say, “I hope I can help you,” and express a doubt.
I had no doubt when I told her to go into a trance. I had no doubts about her.
(Erickson points to Carol.) I had no doubt about those two either. (Erickson
points to two women on the couch.) I was utterly confident. A good therapist
should be utterly confident. (Zeig, 1980, p. 61)

Erickson’s critique of therapists who express a doubt is the exact point. Cha-
risma includes confidence, a wish to help the client and an implicit sense of
wonder and awe at being part of the healing process. In this Reality B view
of charisma, it should not be confounded with egotism or arrogance. This is
an easy area for therapists to become confused. First of all, many therapists
believe strongly that the ability to change lies within the client and is simply
facilitated by the therapist. In fact, any statement that implies that people
change due to the power of the therapist is seen as self-centered and mis-
guided. Instead, better to cultivate a humble stance and be a midwife to the
birth of the client’s true nature.
This kind of humbleness is a perfectly fine stance toward the therapeutic
relationship with two caveats. First, “humble” therapists must be aware that
some clients will need a different style of relationship. For example, they may
grow faster with a confident expert, or with a humorous provocative style like
Farrelly, or a mystifying shaman like Erickson. Second, they need to develop
their humbleness to the point where clients recognize it—feel it—as remark-
able. The title of this chapter is “Becoming Remarkable.” Humbleness, Love,
Expertise, Humor, Mysticism, and many more qualities can be the organizing
principle and the beginning point of a particular therapist’s development of
charisma. Humbleness can be as charismatic as Expertise; Love and Accep-
tance taken to a profound place are as charismatic as Glasser’s Responsibility.
Recalling the Dalai Lama quote about the unity of wisdom and compassion,
all of these stances eventually unite with the others. Start wherever you are
most comfortable; by the time your choice has flowered into charisma, you
will have encompassed many of the other styles and forms as well.
Schore makes an important contribution to the discussion of charisma. In
his language, therapeutic charisma means that the right brain of the client
recognizes the capacity of the right brain of the therapist. It happens quickly
 Becoming Remarkable 345

and unconsciously. And this kind of recognition is central to establishing a

“remarkable” therapeutic alliance.
Charisma is different than ordinary kindness and intelligence. Certainly,
Tillich has already taught that the path is both flat and hierarchical and in that
sense, all wisdom and all compassion—regardless of how ordinary they are—
participate in ultimate wisdom and ultimate compassion. That said, when a
therapist recognizes that she needs to be “remarkable” to achieve effective-
ness beyond the norm, she has taken the first step toward that achievement.
When Martin Luther King was the primary leader of the civil rights
movement, he not only contributed his individual powers of intelligence,
perseverance, and hard work, he also was able to call on all the traditions
surrounding justice and freedom implicit in the culture. When a listener’s
eyes well up with tears of inspiration as they hear King’s “I have a dream”
speech, the emotion experienced is not directly due to King. His words, man-
ner, and the context have allowed the listener to access all their previously
established feelings about freedom and justice—every exposure to these
concepts throughout their life comes into the present. Like any inspirational
speaker, he takes us into “sacred space” and invites us to feel and experience
the “divine emotions.” In this sense, King becomes an embodiment of the
archetype of freedom and justice and is no longer simply an individual.
Similarly, when a therapist like Milton Erickson has used hypnosis to con-
nect to higher order principles like the unconscious mind and magical heal-
ing—ultimate concerns—he is no longer simply an individual. Rather, he is
both an individual and the archetypal representative of those higher values.
Is it any wonder that a client will recognize such a person as empowered or
authorized to shift the nature of Reality—to alter the threads of the Nomo-
logical Net?
There is a helpful contribution from the phenomenology of religion that
can shed light on the nature of this kind of charisma. In 1923, Rudolf Otto
wrote a short book entitled The Idea of the Holy. Otto was an expert in the
phenomenology of religion; that is, he attempted to study and understand
religious feelings and God as phenomena—as objects of experience. In so
doing, he came up with a definition or a description of what humans experi-
ence—across time and culture—when they encounter the Holy.
Otto described the numinous experience of the encounter with the Divine
using the following Latin phrase: mysterium tremendum et fascinans. The
experience of God is absolutely mysterious—the wholly other; that which
is irreducible and unnamable. Past the core-level mystery, the Holy is expe-
rienced by humans along two dimensions. The first is tremendum, an over-
whelming power and awe that makes us shake and tremble. And the second
dimension is fascinans, that which attracts and comforts, that which is merci-
ful and gracious.
346 Chapter 15

It is not a coincidence that Otto’s description of the Holy is virtually iden-

tical to the Buddhists’ two principles of wisdom and compassion and to the
common factors definition of the therapeutic relationship. What makes Otto’s
definitions so helpful is that the phrase mysterium tremendum et fascinans
evocatively encompasses the sense of charisma sought by Reality B thera-
pists. The Latin phrase resonates with a sense of the numinous and all the
implicit connotations of mystery, awe, and love.
It is certainly a form of idolatry to attribute actual mysterium tremendum et
fascinans to a person regardless of how gifted they might be. Otto intended
them to be descriptions of the divine, not the human. However, the ultimate
concern always participates in the Ultimate and it is entirely appropriate for
clients to experience mysterium tremendum et fascinans with their therapist
when the therapist is consciously and unconsciously attempting to be true to,
manifest, and embody their own ultimate concern. The therapist, of course, is
not divine; but for the client, the therapist can channel divine energy.
Jaye Haley and John Weakland, both well-known and powerful therapists
in their own right, had this to say about their experience of mysterium tremen-
dum with Milton Erickson. It is both interesting and significant that they actu-
ally use the word “shake” as part of their description.

Haley: . . . I think he got more confronting as he got older, and I think that makes
people feel he was more a confronting therapist than he really was in our day. I
think perhaps he confronted more when he had fewer skills of physical control.
Because we really remember him as a very accepting and joining sort of a thera-
pist, and I think a lot of people don’t think of him in that way.
Weakland: I certainly remember him in the early days as someone who was
accepting. Also, at the same time, as someone you could readily be fearful of
because it was easy to see he was powerful and penetrating even while being
accepting. You could shake a little about it as a client. (Haley, 1993a, pp. 94–95)

Client recognition of these “divine” qualities will vary from person to person
and one level of consciousness to another. In this next example, Stephen Gil-
ligan documents his response to Erickson’s therapy.

Some of the most profound experiences of my life came during trance sessions
with Milton Erickson. They are difficult to describe in words. I would sense
myself in some amazing space of infinite possibilities, without boundaries or
dualism. Each experience was perfect within itself, each moment a new learn-
ing or discovery. At some point I would find myself wondering who and where
I was. I would then be startled to realize that the field that was holding me was
Erickson! And his presence was clearly “inside” of me, inside the boundaries
I had so carefully constructed to deny anyone access to my deepest self. My
budding anxiety over this realization would be almost immediately met and
 Becoming Remarkable 347

assuaged with a kind reassurance (from Erickson’s nonverbal presence) that I

needn’t worry, everything was safe, and this was a place of unconditional accep-
tance. (Gilligan, 2012, p. 143)

Gilligan’s experience certainly epitomizes mysterium facinans—“kind reas-

surance . . . that . . . everything was safe”—and mysterium tremendum—
“amazing space of infinite possibilities without boundaries or dualism.” Did
every client experience this with Erickson? Of course not: this experience
was at the intersection of Erickson’s ultimate concern and Gilligan’s ultimate
concern. But the experience leaves little doubt of Erickson’s power in Gil-
ligan’s life.
Did Erickson have the same experience as Gilligan? Almost certainly
not. This experience was facilitated by Erickson but generated by Gilligan.
However, Erickson “owns” part of the credit for the healing experience. His
ability to cultivate his own ultimate concern—and to embody it—opened the
door for Gilligan’s response.
The therapist’s relationship with his own ultimate concern can generate
altered states that are different than the client’s but equally powerful. As
discussed above, postmodern therapeutic ethics must be centered in both the
therapist’s ultimate concern and the therapist’s attempt to discern, align with,
and serve the client’s ultimate concern. In this sense, the effective therapist
is involved in manifesting—at least in some sense—her own ultimate con-
cern and the client’s. When speaking of mysterium tremendum et fascinans
it should be apparent that the human being that is the therapist is not being
elevated; rather, the existential and spiritual forces he serves are moving
through him. Barry Michels tries to describe his version of this experience.

The more I used the tools, the more clearly I felt that these forces came through
me, not from me—they were a gift from somewhere else. They carried an
extraordinary power that made it possible to do things I’d never done before.
Over time, I was able to accept that these new powers were given to me by
higher forces. (Stutz & Michels, 2012, p. 19)

In the next quote, Erickson agrees that his choices in therapy are coming
through him; in contrast to Michels, he attributes this flow to his “uncon-
scious mind.”

“I don’t know. I don’t know what I’m going to do, I don’t know what I’m going
to say. All I know is that I trust my unconscious to shelve into my conscious
that which is appropriate. And I don’t know how they’re going to respond. All
I know is that they will respond. I don’t know why. I don’t know when. All I
know is that they’ll respond in an appropriate fashion, in a way which best suits
them as an individual. And so I’ve become intrigued with wondering exactly
348 Chapter 15

how their unconscious will choose to respond. And so I comfortably await their
response, knowing that when it occurs, I can accept and utilize it.”
He paused, his eyes twinkling. “Now I know that sounds ridiculous. But it
works!” (Zeig, 1982, p. 92)

What is the difference between Michels’ “higher forces” and Erickson’s

“unconscious mind”? Obviously Michel’s explanation has a religious conno-
tation and Erickson’s does not. Experientially, however, the two descriptions
seem highly similar. As practices, it might be argued that Michels infuses
his work with more numinosity and is more conducive to egolessness, but
given Erickson’s success with so many clients, it is difficult to argue that his
approach is less mysterium. In addition, the way in which Erickson refers to
the unconscious, both in this quote and in other therapeutic examples, makes
it clear that he considers the unconscious an infinite repository of creativity
and wisdom—in short, an ultimate concern. And Tillich reminds us that all
ultimate concerns point to the Ultimate equally.
The perennial philosophy argues that both Michels and Erickson are work-
ing with the same healing principles in spite of the fact that the forms are
so different. Both men are making their own ultimate concern central in the
work with and relationship to the client. The clients “feel” the presence of
the therapists’ ultimate concern—probably through Schore’s right brain-to-
right brain process—and it opens access to their own ultimate concerns. Even
without literally invoking God or the Divine—as Michels did in his example
of the Grateful Flow in the last chapter—the clients are being invited to con-
nect to their own ultimate concerns.
A number of therapists might be appalled by the clear hierarchy between
therapist and client in this explanation. As the initiator of the experience, the
therapist has a unique role and is raised above the client in a literal sense. Yet
Tillich’s concept that the path is both hierarchical and flat can reconcile this
dilemma. In order to manifest the therapist’s ultimate concern, there must be
a quality of surrender in the therapist. In order to feel and evoke the client’s
ultimate concern, there must be a quality of egolessness in the therapist. In the
Michael’s quote above he emphasizes that the “forces came through me not
from me” and, in that sense, Tillich’s flattening of the hierarchy is paradoxi-
cally maintained even when the therapist must take the lead.
The key to generate these kinds of experiences in clients is that the thera-
pist must feel “radical”—as if they are always coming from the edge of the
Abyss. Swami Vivekananda says, “Dare to be free, dare to go as far as your
thought leads, and dare to carry that out in your life” (2015a, p. 8). If the
therapist lives safely inside the Net, the right brain of the client will somehow
know that. The modest, positive effect will be there but not the sense of cha-
risma. That said, humbleness, egolessness, compassion, and empathy can be
 Becoming Remarkable 349

as radical as confidence, penetrating questions, and the provocative trickster.

The Mysterium aspect of the definition is the sense that the therapist some-
how is outside this normal world. Fascinans is equivalent to Tremendum.
Virginia Satir in her time was as famous for her humbleness and open heart
as Erickson was for his shamanic power. She had the ability to say the sim-
plest things and they would impact the client as profoundly as Glasser’s call
to fulfill your potential. For example, the following “hug” prescription is not
much in itself, but it was transformational when uttered by Satir.

We need 4 hugs a day for survival.

We need 8 hugs a day for maintenance.
We need 12 hugs a day for growth. (as cited in Hudson, 2011, p. 127)

Similarly, when she invited a client or a family into a constructive and egali-
tarian relationship, her words had profound impact.

I want to love you without clutching, appreciate you without judging, join you
without invading, invite you without demanding, leave you without guilt, criti-
cize you without blaming, and help you without insulting. If I can have the same
from you, then we can truly meet and enrich each other. (as cited in Grotberg,
2003, p. 73)

When reading a vignette, it is easy to be more impacted by the provocation

of Farrelly or the gracefulness of Gilligan yet the therapists who choose, like
Satir, the Borofskys, and Levine, to concentrate on connection and the heart
are just as radical, just as mysterium, and just as effective.
The first step toward becoming a remarkable therapist is overtly and con-
sciously seeking charisma. The first limit to therapeutic power is the capacity
of the therapist to ask for it. Clearly such a request requires the therapist to
address potentially confounding issues such as egotism and self-centeredness.
Erickson worked around this dilemma via attributing his power to the chan-
neling of the unconscious; Michels recommends working with more overtly
spiritual attributions. Regardless, both lean heavily on the concept of the
ultimate concern.
All seeking requires following your own path and having the courage of
your own convictions. Vivekananda exhorts us: “You have to grow from the
inside out. None can teach you, none can make you spiritual. There is no
other teacher but your own soul” (Swami Vivekanada, as cited in Chocka-
lingam, 2014, p. 65). Radical boldness is also an ultimate concern. Perhaps
one of the best descriptions of this concept comes from mythologist Joseph
Campbell. Campbell was describing how to search for the Holy Grail, the cup
that brings healing and Eternal Life.
350 Chapter 15

You enter the forest

at the darkest point,
where there is no path.
Where there is a way or path,
it is someone else’s path.
You are not on your own path.
If you follow someone else’s way,
you are not going to realize
your potential.
(Campbell, 1990, p. 19)

CLIENT-CENTERED THERAPY AND

THE ULTIMATE CONCERN

The fabled musk deer searches the world over for the source of the
scent which comes from itself.
—Ramakrishna, The Gospel of Sri Ramakrishna (1910)

The lack of effectiveness of techniques and systems forces us to cultivate the

interiority of the therapist—the charisma—versus the exterior world of privi-
leged knowledge. This is well and good from one perspective but it leaves
constructionism open to the criticism that the client is reduced to a passive
object with no real power, influence, or responsibility. It is more than possible
to accept the need for therapeutic charisma logically and continue to have a
feeling that we are heading in the wrong direction. Something that moves the
client back to the center seems required.
Historically, the first significant promotion from “patient” to “client”
was, of course, secondary to the work of Carl Rogers. His client-centered
approach emphasized the power of the person and saw the therapist as more
of a midwife.

In my early professional years I was asking the question: How can I treat, or
cure, or change this person? Now I would phrase the question in this way: How
can I provide a relationship which this person may use for his own personal
growth? (Kramer & Rogers, 1995, p. 32)

Postmodern therapies embrace this Rogerian perspective and carry it even

further. Given that Postmodernism is suspicious of simple assertions of
power, authority, and expertise—often seeing them as assumptions that
marginalize certain groups and subcultures—a simple endorsement of the
 Becoming Remarkable 351

concept “cultivating therapist charisma is the key to being a more effective

therapist” is an anathema.
More specifically, narrative therapy (Madigan, 2012)—arguably the pre-
eminent postmodern therapy—is exquisitely sensitive to power relationships
in the culture. Not only do they believe that the medical model works to
stabilize the client in his current identity and dilemma, they also believe that
psychology often becomes a force for oppression and inequity, particularly
for liminal and disenfranchised classes of people. Narrative therapy has a
commitment to identify those hidden and implicit power relationships, bring
them to the surface, and dispute their validity.
Narrative therapy argues that traditional psychology not only marginalizes
certain groups, its very structure implicitly creates oppression and inequality.
As part of exploring this concept, narrative therapy provides one of the most
profound and detailed critiques of prevailing psychiatric practices available.
More specifically, since it believes that a person’s pathology is constructed,
it accuses psychiatry of inappropriately pathologizing patients to support
guild power. In response, narrative therapy attempts to put the rights to an
individual’s story back in his own hands. Stephen Madigan (2012) feels that
this is the central theme of his book.

Finally, the primary question I attempt to raise in the book is based on a rather
simple question: Who has the storytelling rights to the story being told? (Kindle
Locations 520–535)

Put another way, narrative therapy exposes the power politics of psychology
and psychiatry and asks, “What right do mental health experts have in terms
of defining the identity and reality of their clients?”
As might be expected, narrative therapy has a profound commitment to
flatten human hierarchies; this commitment specially focuses on minimizing
the hierarchy between therapist and client.

Early on in his therapeutic practice, Epston seemed to make it his mission to

work against any form of therapy that acted as a ritual of degradation—in which
one party (i.e., the professional helper) would act to make the other party feel
“less than.” For Epston, taken-for-granted assumptions of everyday life became
a focus of inquiry and celebration. (Madigan, 2012, Kindle Locations 632–634)

To this end, narrative therapists often pose new frames to clients in the form
of questions instead of statements. The aim, of course, is to emphasize that
the client already has the wisdom, the power, and the answer; the therapist
simply invites what is already present to manifest itself. Asking questions,
352 Chapter 15

of course, also minimizes the identities of the “therapist as expert/client as

dependent.”
Given this brief summary of some of the core principles of narrative
therapy, imagine how its adherents might respond to concepts like charisma,
“secret knowledge,” and therapeutic wizards. Regardless of the positive
intentions behind these concepts, each of them is implicitly hierarchical and
each one contains seeds that could develop into ways of exploiting, dimin-
ishing, and degrading clients. Moreover, narrative therapists believe that
assumptions of expertise are already deeply embedded in any psychothera-
peutic system that is related to medicine and psychiatry. A psychotherapeutic
system that emphasized developing therapist charisma could easily be seen as
dangerous and as moving in an inappropriate and unhelpful direction.
If this is true of narrative therapy, such concerns are even more pronounced
in another postmodern therapeutic system, Collaborative Therapy. In order
to minimize power imbalances as fully as possible, Harlene Anderson,
developer of collaborative therapy, presents her vision of the ethical client-
therapist relationship.

Conversational Partners. The collaborative therapist and client become conver-

sational partners as they engage in dialogical conversations and collaborative
relationships. Dialogical conversation and collaborative relationship refer to
the shared inquiry process in which people talk with each other rather than to
each other. Inviting this kind of partnership requires that the client’s story take
center stage. It requires that the therapist constantly learn—listening and trying
to understand the client from the client’s perspective.
Client as Expert. The collaborative therapist believes that the client is the
expert on his or her life and as such is the therapist’s teacher. The therapist
respects and honors the client’s story, listens to hear what is important for the
client, and takes seriously what the client says and how they say it. This includes
any and all knowledge; for instance, whether dominant cultural discourse or
popular folklore informs the client’s descriptions and interpretations, and it
includes the many ways that the client may express his or her knowledge. For
instance, the therapist does not hold expectations that a story should unfold in
a chronological order or at a certain pace. The therapist does not expect certain
answers and does not judge whether an answer is direct or indirect, right or
wrong. . . .
Not-Knowing. The collaborative therapist is a not-knowing therapist. Not-
knowing refers to the way the therapist thinks about and positions themselves
with their knowledge and expertise. They do not believe they have superior
knowledge or hold a monopoly on the truth. They offer what they know or think
they might know but always hold it and present it in a tentative manner. That
is, therapists offer their voice, including previous knowledge, questions, com-
ments, opinions, and suggestions as food for thought and dialogue. Therapists
 Becoming Remarkable 353

remain willing and able to have their knowledge (including professional and
personal values and biases) questioned, ignored, and changed.
Being Public. Therapists often learn to operate from invisible private
thoughts—whether professionally, personally, theoretically, or experientially
informed. Such therapist thoughts include diagnoses, judgments, or hypotheses
about the client that influence how they listen and hear and that form and guide
their questions. From a collaborative stance, therapists are open and make their
invisible thoughts visible. They do not operate or try to guide the therapy from
private thoughts. . . . Keeping therapists’ thoughts public minimizes the risk of
therapist and therapist-client monologue—being occupied by one idea about a
person or situation.
Mutual Transformation. The therapist is not an expert agent of change; that
is, a therapist does not change another person. Rather the therapist’s expertise
is in creating a space and facilitating a process for dialogical conversations and
collaborative relationships. When involved in this kind of process, both client
and therapist are shaped and reshaped—transformed—as they work together.
(Anderson, 2003)

Examining Anderson’s principles, it is clear that she is seriously engaged in

flattening the hierarchy between client and therapist. The therapist is not senior
to the client in any way—not through training, licensure, experience, age, wis-
dom, compassion, or fearlessness. If one takes constructionism seriously—and
believes that there is “no place to stand”—then the only authority for therapy
with any individual comes from the individual herself: “the client is the expert
on his or her life and as such is the therapist’s teacher.” When the credibility of
the “expert who knows the effective technique” is destroyed by research results
and deconstructionism, the only place to stand is in the truth of the client.
Both Anderson in particular and narrative therapy in general are very seri-
ous about conducting therapy without a client-therapist hierarchy. While their
intentions are admirable in terms of social justice and basic human respect,
the problem, of course, is that fundamental reality and constructed reality are
literally suffused by natural hierarchies. Perhaps, the simplest example comes
when working with a child. Given that the child has an undeveloped brain,
conducting therapy without hierarchies makes no sense. Is it really appropri-
ate to make every thought in the therapist “public” when the child lacks the
capacity to understand the thoughts? Even if we grant that Anderson was
speaking about adults, it is clear that adults vary developmentally and fall into
a range from childlike to fully mature. Moreover, Schore’s research implies
that a number of adults have “brain damage” when it comes to affective
regulation. Isn’t there a hierarchy between such people and their (hopefully)
fully developed therapists?
Even in the area of constructed reality there are hierarchies. Glasser argues
that the therapist must understand how to operate in the culture, the Net,
354 Chapter 15

more effectively than the client if he is going to help the client move from
his current position to a new one. Tillich believes that many individuals are
following idolatrous ultimate concerns and are reaping painful results due
to this strategy. Put in Buddhist language, these clients are being driven by
fear and desire—using strategies which are characterized by avoiding what
is feared and desiring what seems rewarding. The Buddhists warn that such
strategies diminish long-term satisfaction and contentment. If a therapist has
understood the implications of the Buddhist teachings about desire/fear and
Tillich’s ideas about idolatry/authenticity, and the client has not, isn’t there
an implicit hierarchy between therapist and client?
And the lack of research support for the effectiveness of techniques adds
another twist. I will defer to an expert in a fundamental reality field, such as
a contractor, because they know how to build a house. But in psychotherapy,
the therapist’s main ability to help me change rests on her charisma, her
personal power, and/or her ability to have an open heart. Her knowledge of
techniques is not going to help me. Given this fact, isn’t it in my best interest
to go to the therapist who has wisdom and openheartedness beyond my own?
I should seek a therapist that seems in some way superior to me if I want to
learn and grow.
Narrative therapists might argue that while all this is true, and makes sense
from the client point of view, it can still be helpful to the therapist to drop the
hierarchy between herself and her client. Certainly, decreasing hierarchy from
a therapist point of view has many benefits including listening more to the cli-
ent, affirming his personhood, reducing dependency on the therapist, and limit-
ing therapist hubris. However, it is more effective to achieve these desirable
results via an alternative approach versus trying to accept arguments about
hierarchies that are simply not true. Hierarchies exist. Typically, clients will
seek therapists that “feel” wiser, more caring and more skillful at living. This is
an inevitable outcome; the problems associated with it need to be dealt with in
some other manner than asserting that hierarchies are odious and destructive.
A closely related issue is the established fact that it is difficult or impos-
sible for the therapist to avoid acting in a hierarchical manner particularly
when it comes to influencing the client. Carl Rogers was famous for attempt-
ing to flatten the client/therapist hierarchy as much as possible and even his
best efforts failed to result in an egalitarian relationship. More specifically,
a number of research studies revealed (Fromme, 2010) that Rogers was
unconsciously emitting nonverbals when working with clients—nonverbals
that urged the clients to focus on what Rogers believed most helpful. In other
words, even when we work as hard as possible to avoid imposing our beliefs
on our clients, even when we try to defer to the concept that client beliefs are
primary and that they are superior in the hierarchy, we unconsciously impose
our own worldview on them.
 Becoming Remarkable 355

After all of the critique of specific weaknesses in the “flatten hierarchy”

arguments, it should be recognized that Anderson, the narrative therapists and
Carl Rogers are not simply outlining a literal psychological technique; rather,
it is more useful to see their prioritization of social justice and equality as an
ultimate concern. As an ultimate concern, one can argue that it should not
be subjected to the same analyses used with simple intellectual arguments.
Rather, it should be seen as a conveyer of higher purpose and meaning and
judged from that point of view. In this sense, the concept of flattening the
hierarchy between therapist and client is fundamentally useful and helpful.
The literal incongruences of the position can be disregarded and the inspira-
tional and motivational aspects embraced.
Many, many therapists have had the sense of “no hierarchy” as they work
with clients. They feel like the ultimate authority on what should be done in
therapy resides in the client and the therapist’s job is to listen carefully, help
it come to the surface, and serve it. As the therapist operates from this per-
spective, they often feel as if something from the client comes through them.
The therapist is not generating the concepts and directions; it all arises from
somewhere inside the client. This is an experientially validated state of mind,
not a carefully reasoned argument.
To the degree that narrative therapy attempts to point toward and elicit
this kind of experience in the therapist, the concept of flattening hierarchies
is unassailable. It is more like a spiritual experience than a psychological
approach. Moving toward this kind of ultimate concern often creates an
altered state in the therapist which can be communicated implicitly to the
client. The client feels heard and honored; their core self feels affirmed and
empowered. The therapist feels humble; moreover, they often have the sensa-
tion that they are touching a core experience of love and connection.
In sum, flattening hierarchies as an ultimate concern can be helpful to both
therapists and clients. Unfortunately, if taken more literally, it can confuse
therapists about the need to cultivate their own charisma, take responsibility
for leadership, and manifest a healing vision.

CLIENT-CENTERED ETHICS

By what authority are you doing these things? they asked. And who
gave you authority to do this?
—Mark 11:28

The fact that techniques are not responsible for outcomes in psychotherapy
creates an unusual ethical dilemma. In most professions, the healer is able
to state that his knowledge of the techniques of his profession is responsible
356 Chapter 15

for his outcomes. Take, for example, a physical therapist. The twenty-eight-
year-old physical therapist has no doubt about her authority to treat a fifty-
six-year-old survivor of an automobile accident. She has the right to treat
him because she has been trained in effective techniques—techniques which
she can teach and techniques which will lead to recovery. She will still need
a code of ethics consisting of principles such as do no harm, put the client’s
welfare before her own, and maintain confidentiality. But she does not need
to worry about the most fundamental ethical question: what right do I have to
treat this patient and how can I be confident that I am helping him?
When power lies in the technique, then I can attribute the credit for change
to the technique; I am simply an ordinary man in possession of a powerful
tool. If I am effective, and it is due to “standing on the shoulders of the giants
that came before me,” then it is relatively easy to preserve humbleness, avoid
corruption and resist the seduction of power. Unfortunately, this faith in tech-
niques is no longer available after analyzing the outcome research findings.
Without effective techniques, clients only change because of my charisma
and caring.
The obvious alternative—and one emphasized by many therapists, includ-
ing many therapeutic wizards—is attributing change and growth as secondary
to power in the client; the therapist may be the midwife at the birth of the
new reality, but the client is ultimately responsible for all growth. This always
sounds good, especially when one says it to a client, yet it begs the central
question. If the client is actually the one responsible for change, then why did
they need to come to the therapist? If there is really little or no power in the
therapist, why are some therapists consistently better than others at facilitat-
ing change? The moment the change agent is significantly more effective than
the average therapist, the superiority must be in the therapist, not in the client.
Moreover, when techniques are responsible for change, then it is relatively
easy to sustain the relationship. The therapist simply has to care for the cli-
ent, monitor the response to the techniques, and alter them when appropriate.
Without techniques the situation is much more demanding. Imagine a finan-
cial planner who is selling the client a good financial product that is making
money. The satisfaction of making the money virtually ensures that the client
will appreciate the relationship. Contrast that with the financial planners in
chapter 1 that Kahneman used as examples. Since they have no real expertise
at stock picking, they will have to sustain the relationship with charm and
charisma and even misinformation, especially since their stock recommenda-
tions will regularly move in the wrong direction.
Therapeutic relationships are easier given that there is an expected mod-
est, positive result from therapy; it is kind of like the stock pickers sustaining
relationships during an “up” market. Even so, it is much more challenging
to work with clients when one knows that the techniques are not responsible
 Becoming Remarkable 357

for the outcomes. When I know that all my “techniques” are really “rituals,”
I am left with the feeling that I am responsible for the outcomes; this feeling
can make me anxious or grandiose.
In such ambiguous situations, the person of the therapist and the person of
the client loom large. One can even argue that—bereft of the ability to lean
on the power of the technique—it is almost impossible to be truly client cen-
tered. Without techniques, I am compelled to take stands that are not neutral;
I am required to move the client in one direction or another according to my
best judgment. Gergen comments:

Unlike traditional therapists, the constructionist realizes that there is no value

neutrality in the therapeutic relationship. Every intervention will favour some
form of life, while undermining others. The therapist who favours heterosexual-
ity closes the door on homosexual options; in favouring the client’s industrious
productivity the joys of hedonism remain unrealized; “empower” the male and
the female loses options. (Gergen, 2009, p. 138)

In sum, the inability to lean on the power of techniques forces the therapist
to face the fact that therapy results in an imposition of therapist values on
the client. Bereft of techniques, I must take responsibility for the conduct of
therapy.
If one can’t attribute the power of change to the technique, and it cannot be
attributed in a straightforward manner to the client, what is left? The simplest
answer to this question—and one used by most spiritual seekers—is to attri-
bute the power to change to a higher power. You, the therapist, are an instru-
ment of some higher power working through you. Even if techniques are not
the answer, I can sustain my humbleness and my egolessness by asserting
that I simply have an ability to surrender to a power that works through me.
I am not better in myself than the average therapist; in fact, I am not even
better than the average client. However, I can be more helpful in that I chan-
nel the source more effectively. I am only special and superior in my ability
to connect to the higher power and to allow it to use me. In some ways, this
is similar to giving credit for change to the powerful technique; once again,
it is not me that helped you change, but something that comes through me.
But many therapists do not have a direct relationship with a higher power
and this kind of religious language would feel foreign to them. Interest-
ingly, however, if one examines Rogers’ famous prescription that therapists
should approach the client with “unconditional positive regard,” one quickly
spots the spiritual incongruity. Unconditional is equivalent to infinite. It is a
spiritual tautology that only God can be loved unconditionally and only God
loves us unconditionally. Yet Roger’s statement is one of the most oft-quoted
comments defining the ideal therapeutic relationship. Does it actually require
358 Chapter 15

therapists to be “God-like” to fulfill the Rogerian ideal of the therapeutic

relationship? The simple answer—which is of course impossible—is: yes.
Normally, when one rests on the power of techniques this kind of god-like
ability—to love unconditionally—is rarely needed nor is it examined closely.
But without the shelter of techniques, unconditional positive regard becomes
the technique. And the implication is that the therapist is required to achieve
an “imitation of Christ-type” consciousness.
Almost all therapists recognize that they never achieve unconditional
positive regard; they simply hold it as an ideal which points the way toward
a healthy therapeutic relationship. This concept of “points toward” is, of
course, the heart of the Tillichian model. His core argument is that the ulti-
mate concern—if it is authentic and not idolatrous—points beyond itself
toward something Infinite.
Examining the client relationship from an ultimate concern point of view
opens up a new realm of possibilities because in the area of ultimate concern,
there is no hierarchy between me and the client. Recall that the Tillichian path
is both hierarchical and flat. A young person’s ultimate concern, which might
be focused on achieving recognition by the adult world, is just as connected
to the Source as the middle-aged person whose ultimate concern is focused
on sustaining love in a long-term marriage. Certainly, the challenge of the
middle-aged person requires a higher level of maturity and depth—hence it
is hierarchical; conversely, the degree to which both challenges point toward
the Source are equal.
I have my own path and my own dialog with my ultimate concern.
Similarly, my client has her own path. Buber quotes a Hasidic proverb that
addresses this important concept:

The same point is made by the Hasidic rabbi, Susya, who shortly before his death
said, “When I get to heaven they will not ask me, ‘Why were you not Moses?’
Instead they will ask ‘Why were you not Susya?’” (Buber, 2014, p. vxvii)

This quote implies that each person has a unique path to individuation.
Using Tillich’s concepts of idolatry/authenticity suggests that the therapist
is ethically responsible for discerning whether an intervention participates
in the client’s unique path—whether it is authentic—or whether it pulls the
client off her path—whether it is idolatrous. This places the therapist in the
middle of two sets of ultimate concerns: her own, with which she needs to
stay aligned to allow her own creativity and power to flow, and the client’s
ultimate concern, which must validate and support any intervention for the
therapy to be ethical and appropriate. And since both ultimate concerns par-
ticipate equally in the infinite, there is no hierarchy between therapist and
client.
 Becoming Remarkable 359

Of course the therapist “steps down” from that level of consciousness and
plans and executes an intervention in constructed reality. The planning and
execution of the intervention are hierarchical. But planning and intervention
rest on the ability to discern the ultimate concern of the client. In that sense,
the client’s ultimate concern is more important and all discernment about
it is nonhierarchical. In sum, hierarchy is paradoxical; it both exists and
doesn’t exist in the therapeutic relationship once the client’s ultimate concern
becomes paramount.
The Jerome Frank conceptualization of therapeutic processes as rituals
has something important to add here as well. The key to make the ritual
meaningful and effective is to align it with the client’s primary issue; the
ritual must include an explanation as well as provide a passage through an
experience which justifies the resolution of the challenge. The client’s issue
is connected symbolically to her ultimate concern; essentially the resolution
of the issue allows for an evolutionary move toward the ultimate concern. In
this sense, the client’s ultimate concern is at the center of every therapeutic
ritual and the therapist is always required to adapt to the client’s current
consciousness.
Making the client’s ultimate concern central in the therapeutic process
allows the therapist to put much of the power of change back into the client.
It is easy to feel humble standing before the client’s ultimate concern. This is
useful in that the less ego, the easier to discern the client’s next step on her
path. And, similarly, the more humble I am, the less my own material pollutes
and confuses the situation.
This does not imply that every therapist needs to be a spiritual devotee in
order to be more effective nor is every practitioner required to be some kind
of believer. Recall that Tillich’s ultimate concerns point beyond themselves.
If one therapist has an ultimate concern connected with recognizing and vali-
dating the emotional side and another is committed to embracing the shadow
in a profound manner, these sorts of concerns can be every bit as empowering
as directly affirming some kind of relationship to the Source.
Standing in one’s own ultimate concern and attempting to discern the cli-
ent’s path is the only meaningful answer to “by what authority do I heal?”
I heal by the authority implicit in my client’s ultimate concern. It is open to
me when I stand in my own ultimate concern. And, obviously, part of every
therapist’s ultimate concern includes her identity as a healer.
In sum, the rejection of the power of techniques creates new ethical dilem-
mas for therapists. If superior mastery of techniques is not the source of
therapeutic power, then all that is left is something special in the therapist.
Obviously, the narcissistic assumption of therapist superiority leads to a dark
and confused place, both for clients and for therapists. The “way out” of the
dilemma is through the ultimate concern.
360 Chapter 15

It is ironic that something as deconstructive as postmodern thinking essen-

tially forces therapists and coaches into a choice between “I heal due to my
personal charisma” and “I heal because I align myself with forces greater than
myself.” Postmodern thought is famous for supporting the “death of God.” It
is strange to think of it as a force that confirms the importance of the ultimate
concern. Yet the very act of entering into a relationship with another human
being with the intent to be of service forces the therapist into a position where
they must affirm that they heal from their personal power and superiority or
they heal via channeling some higher ideal or force.

THE EVOLUTIONARY MODEL

The only religion that ought to be taught is the religion of

fearlessness. Either in this world or in the world of religion, it is true
that fear is the sure cause of degradation and sin. It is fear that brings
misery, fear that brings death, fear that breeds evil. And what causes
fear? Ignorance of our own nature.
—Swami Vivekananda, The Complete Works
of Swami Vivekananda (1907)

Every psychotherapeutic technique has its own implicit assumptions about

the structure of reality and the meaning of life. In this sense, it is possible to
construct an evolutionary hierarchy of human development using schools of
psychotherapy. Whether one uses Maslow’s hierarchy, or Kohlberg’s sense
of moral development, or Tillich’s progression from idolatrous to authentic,
each school of therapy can make a contribution at a different developmental
stage. For example, using Kohlberg’s model, reality therapy and cognitive
therapy embody Kohlberg’s conventional stage, narrative therapy—with
its emphasis on social justice—embodies a social contract orientation, and
Buddhist therapy orients itself toward Universal Principles. In this sense, the
therapist who is interested in mastering new schools of thought can concep-
tualize this learning as an evolutionary process. And, since this is an evolu-
tionary process, as the therapist learns to embody a new approach, he has the
opportunity to develop his connection to his ultimate concern and increase
his charisma.
Of course, the focus of this book is on Reality B; hence, this evolutionary
model of psychotherapy schools needs to be discussed in terms of constructed
reality instead of fundamental reality. More specifically, each school can be
described in terms of its geographic location in constructed reality—in terms
of the way in which it participates in the Net-Abyss dialog. In this sense, fully
mastering any school of therapy implies that the therapist understands and is
 Becoming Remarkable 361

competent in terms of that particular Abyss-Net interaction—the therapist

comfortably dwells in that level of consciousness. For example, to effectively
perform Apollonian techniques like reality therapy or CBT, the therapist
needs to be an expert on culturally defined reality and at ease with concepts
such as implicit judgments about healthy/unhealthy and right/wrong. To work
with psychodynamic and depth psychologies, the therapist must be comfort-
able with exploring the personal and collective unconscious and be able to
distill meaning from pathology. Working intentionally with altered states
requires the therapist to have personal experiences at the edge of the Abyss.
And integrating spirituality into psychotherapy rests on one’s capacity to
immerse oneself in the Abyss.
Each developer of a therapy school essentially believed that they were
introducing a new way to understand human beings and a new approach to
healing and change. The founders felt that they were opening a new view
of reality, one that would expand and complement extant views. In virtually
every example of new thought, one can feel the excitement of the devel-
oper—the sense that these new ideas will push the frontiers of knowledge.
Experiences such as these are easy to conceptualize as expressions of the
developer’s ultimate concern. The implicit excitement embodies the devel-
oper’s sense that they are part of an age-old quest for knowledge and truth.
In this sense, striving to master an evolutionary progression of psycho-
therapeutic techniques requires the therapist to undertake an inner pilgrim-
age. Recall that pilgrimages occur in sacred space. Clearly, simply learning
a new technique like EMDR or DBT does not guarantee that the learner has
moved into sacred space. In addition to attaining the technical competence,
the learner needs to attempt to recreate the initial excitement of the developer
and move into sacred space by feeling that she has a new experience—a
transformed sense of reality. Each of these techniques allows a pure experi-
ence of a different form of the Net-Abyss interaction. Trying to help a client
see and experience that interaction will immerse the therapist fully in the
same experience. In this manner, each session becomes an opportunity for the
therapist to have a personal encounter with her own growth and development
through facilitating the client’s growth and development. The evolutionary
model is not simply about moving from one technique to another. Instead, it
is the attempt to master a technique through reexperiencing the developer’s
connection to his ultimate concern and the geography of constructed reality.
And the mechanism of this connection is the attempt to introduce the experi-
ence to the client.
Returning to the example of Mother Teresa offered earlier: she was
attempting to purify her heart by conducting programs for the poor. In the
evolutionary model, we are attempting to master constructed reality by doing
therapy with clients. Since the perennial philosophy suggests that mastery of
362 Chapter 15

constructed reality is essentially an existential/spiritual process, the pursuit of

the evolutionary model occurs in sacred space. Eliade might argue that each
mastery experience of a different therapeutic approach is a hierophany.
As an example, I practice EMDR on a fairly regular basis. I’m not too
concerned about whether there are any neurological underpinnings to the
technique although I am sympathetic to EMDR’s continual attempt to find
such underpinnings. Instead, I simply practice it as another technique—simi-
lar to hypnosis—which is conducive to clients entering an altered state. It’s
especially useful now because its advocates have created so much good press
that many clients have strong, positive expectations about the technique.
From my point of view, I simply explain to the client that his mind has
the ability to make new connections around the content of a traumatic event.
These new learnings will result in the ability to integrate the event in a new
manner that will result in healing and growth. I continue by pointing out
that it is a process; we will begin with whatever experience his mind/feel-
ings generate and then follow them until they eventually culminate in a good
result. Then I begin to wave my hand and process the resulting experiences
with him.
He is working on resolving his trauma. I am watching him and marveling at
how quickly and effortlessly humans can slip into altered states and how fluid
the strings of the Net become in an altered state. I am also witnessing how
easily humans move toward healing when they are given permission. My cli-
ent’s experience has allowed me to move into my own altered state. I exist at
the edge of the Net/beginning of the Abyss. Everything seems possible; often
everything seems effortless. The numinosity of the Abyss surrounds me; as
we work through the chain of experiences, the positive movement toward
healing feels as if it affirms the oracular nature of the Abyss. Hopefully, the
client has an experience of healing. Just as hopefully, I have an experience
of meaning and I touch the sacred space that exists at the boundaries of the
Abyss.
I don’t feel concerned about the way in which my experience diverges from
my client’s experience. She may have the feeling that I am using a technique
that has been scientifically verified as effective with PTSD. I imagine that she
believes the eye movements have a neurological basis. I have explained that
the research has shown that many people are helped by EMDR and, although
no one knows for sure how it works, EMDR theorists postulate a neurologi-
cal effect. The structure of her ritual is intact including an explanation for her
suffering, an explanation of why the ritual should resolve it, and the ritual of
the eye movements themselves. Hopefully the right brain-to-right brain con-
nection between us will allow her to recognize me as a credible healer. And,
certainly, my ability to be excited and moved both by her altered state and
by the ways in which her psyche guides her in making new connections does
 Becoming Remarkable 363

nothing but enhance my relationship with her and my charisma. Our separate
“truths” may appear to diverge but actually they are not as separate as they
may seem at first glance.
Moving to a more pragmatic perspective, the evolutionary model does not
have rigid rules. It is not necessary to literally master every major school of
therapy. Indeed virtually any complex school—for example, psychodynamic
psychotherapy—can be practiced from an Apollonian or Dionysian point of
view. Switching schools—which symbolizes switching world views—can
be seen as a potentially helpful but not necessary choice. Moreover, every
therapist has their own background and their own choices about what schools
of therapy they have mastered and what approaches they currently use. The
evolutionary model can be adapted to any beginning point.
The secret is that the therapist must feel and believe that he is stretch-
ing himself and venturing into new territory. If the new material feels like
“same old-same old,” it is not part of the evolutionary model. If it feels like
learning a new technique, it is not part of the evolutionary model. If it feels
like adopting a new worldview; if it is a true paradigm shift; it is part of the
evolutionary model. The single biggest sign that one is practicing the evolu-
tionary model is that it feels like the practice of therapy is leading to personal
evolution. This is part of accepting psychotherapy as a vocation instead of a
profession; helping, serving, and personal growth become intertwined.
The efficacy of the evolutionary model rests on a simple set of assump-
tions. If I am already a master of Apollonian techniques such as reality
therapy and CBT, and I add expertise in shadow work and the unconscious
mind, this level of growth should lead to enhanced charisma. This statement
of course depends on the principles enumerated above; I have not simply
mastered the “technique,” I have embraced the essence of shadow work and/
or I have deep, personal encounter with the unconscious. If, indeed, I can
achieve that, then it should result in enhanced charisma.
Similarly, if I can work well with dissociation, or sacred space, or deeply
feel the impact of groups on the individual’s reality structure, I should be a
better therapist/more charismatic than I was prior to my mastery. Moreover,
therapists who limit themselves to one approach—whether through fear, or
programming, or lack of curiosity—should have limited charisma. If these
simple assumptions are true, then training programs and continuing education
should recommend that therapists attempt to master approaches and schools
of thought that they may be unfamiliar with, especially if they have some
resistance or fear about the new approach. The evolutionary model assumes
more mastery equals more charisma.1
The evolutionary model is not limited to learning the next psychological
system that lies closer to the Abyss. It can also occur on a variety of other
dimensions such as an evolutionary approach to wisdom or an evolutionary
364 Chapter 15

approach to self and identity. For example, wisdom can evolve from an Apol-
lonian expertise in the prevailing culture, through the kind of wisdom that
can detect the numinous qualities present when the Abyss breaks into daily
life. Go further and use wisdom to discern what is constructed and what is
fundamental and then proceed to understand the formlessness implicit in a
“kill-the-Buddha” paradigm.
Appendix A, entitled “The Geography of Constructed Reality,” is included
to illustrate some of the many themes that are amenable to the evolutionary
model. In truth, no one can practice one theme without simultaneously par-
ticipating in at least several others. Wisdom requires heart and the evolution
of the ultimate concern is connected to an evolutionary experience of the self.
It is important not to get too literal while still offering enough specificity to
be helpful.
In attempting to accumulate charisma, we must constantly move back
toward the relationship with the client. Everything is possible whenever we
truly encounter the other. Buber’s I-Thou relationship is always only a breath
away. While that may be true, it will be easier to experience my client as a
Thou when my perceptions are facilitated by my own altered state. In this
sense, practitioners of the evolutionary model are always in an altered state
when they are working. It is possible to perform techniques in a standard state
of consciousness, but when one is focusing on psychotherapy as practice,
consciousness is always altered. Psychoanalyst Marjorie Schuman comments:

When we are deeply present with another, transcendent subjectivity can also
occur as an emergent aspect of the relational field. This can be termed a tran-
scendent relational field; it involves an experience of transpersonal awareness.
We may think of such experiences as “blood moment” in which the usual
boundaries between self and other are temporarily relaxed, yielding an interper-
sonal experience of belonging, connectedness, and deep intimacy unbounded
by the sense of separate self. The quality of relatedness can emerge intersub-
jectively in the transference/countertransference when mindful awareness is
brought to bear on the experience of the relational field. This subjective state
cannot be said to “belong to” either patient or therapist. It is felt to be emergent:
arising of its own accord in the mysterious alchemy of the therapeutic relation-
ship. (Schuman, 2017, pp. 78–79)

The attempt to master a new approach is essentially a trance induction for the
therapist. To repeat, the power of the evolutionary model rests on its ability to
take the practitioner out of normal consciousness and land them at the edge of
the Abyss. This is not simply another day at the office. Mastering an approach
is not equivalent to learning a new technique.
In the sacred space opened by the altered state everything is new and
everything is numinous. Certainly, such an experience has the capacity to
 Becoming Remarkable 365

enhance charisma. The question is less “does the evolutionary model work?”
and more “can I dive so deeply into mastery that I can achieve an altered state
and move into sacred space?”

DELIBERATE PRACTICE

There are no beautiful surfaces without a terrible depth.

­—Friedrich Nietzsche, Beyond Good and Evil (1886)

Scott Miller has been repeatedly cited in this book because he has been a
thought leader in terms of popularizing the results of the research—psychol-
ogy’s inconvenient truth. Not surprisingly, he has not been content with simply
exposing the flaws of extant practice; he is also active in developing new mod-
els of training. Miller calls his new model “deliberate practice.” Derived from
the work of Ericsson (1993), in deliberate practice, the practitioner focuses
on the weak points in their expertise. For example, a good basketball player,
who has a relatively weak left-handed dribble, might focus specifically on the
dribble through exercises and drills. Conversely, simply playing regular bas-
ketball games would take a long time to improve the dribble. It is even possible
that the player consciously or unconsciously avoids the left-handed dribble so
much that general play will never improve his skills in this area. Miller states:

So, that’s what led us to the concept of deliberate practice. Most of us go to

work every day and, perhaps surprisingly, given that we spend so much time
at our jobs—more time than we spend with their families—most of us are only
average at what we do. That’s pretty disturbing so, what do top performers do?
The truth is, they practice in a different way. You hear people, myself included,
talk about how they practice but, unfortunately, that kind of practice doesn’t
make them any better. For a while, people like Ericsson et al (1993) and, more
recently, Colvin (2008) and Shenk (2010), have been talking about deliberate
practice. Deliberate practice means that there is a different order to, and level
of investment by, top-performing folks that lead them to a massive knowledge
that is different. It is more nuanced and contextualized and it certainly has more
breath than the average practitioners. So, that’s where the whole idea came
from; that’s a long way around. (Miller & Hubble, 2011, p. 34)

In a variety of skills—like the basketball example above—it is relatively easy

to determine one’s weak points and develop a deliberate practice to improve
the area. In therapy, however, the complexities and relativity of the differ-
ent therapists, clients, and schools of therapy make deliberate practice more
challenging. Miller has come up with a model that attempts to address these
challenges:
366 Chapter 15

First, know your baseline. Rachel (a gifted young pianist) is able to accurately
assess what she does, mindful of what she’s capable of. Second, engage in
deliberate practice—a systematic and critical review during which time prob-
lematic aspects of the performance are isolated and rehearsed or, failing that,
alternatives are considered, implemented, and evaluated. Third, obtain formal,
ongoing feedback. (Miller & Hubble, 2011, p. 25) (Items in parenthesis added)

Miller’s model begins with the concept that the focus is on enhancing the
therapist not on developing systems and techniques. He requires practitioners
to start with self-assessment—an assessment that pays particular attention
to weaknesses. Consulting with mentors and supervisors, and reviewing the
work of master therapists can be helpful at this stage. Next he builds in a for-
mal feedback process. Miller’s primary feedback process is entitled Feedback
Informed Treatment (FIT). The basic practice in FIT involves administering
two brief questionnaires to clients at each therapy session. The first ques-
tionnaire, given at the beginning of the session, records the client’s sense
of ongoing progress. The second questionnaire, given at the conclusion of
the session, records the client’s sense of the relevance and usefulness of the
current session. The questionnaires are scored immediately and the therapist
uses the results to alter her interactions with the client. In addition, in between
sessions the therapist can reflect on the feedback from the questionnaires,
compare the results to baselines from her own practice and the practice of
others, and come up with questions and interventions for the next session.
This process not only has the potential to improve therapeutic outcomes, it
also functions as a method for determining relative therapeutic weaknesses.
Then these weaknesses can be addressed with deliberate practice. A colleague
of Miller, Chow (2014), recently completed a dissertation that attempted to
define and evaluate the deliberate practice model. As part of the dissertation,
he developed the following activities aimed at addressing deliberate practice
weaknesses.

The 10 (solitary) activities were the average number of hours per month spent
on (a) reading psychotherapy and counselling journals; (b) reading/re-reading
about core counselling and therapeutic skills in psychotherapy; (c) reviewing
therapy recordings; (d) reviewing difficult/challenging cases; (e) reflecting on
past sessions; (f) reflecting on what to do in future sessions; (g) writing down
reflections of previous sessions; (h) writing down plans for future sessions; (i)
viewing master therapist videos with the aims of developing specific therapist
skills; and (j) reading case studies.
The nine (non-solitary) activities were: (a) general clinical supervision as
a supervisee without review of audio/visual recordings of sessions; (b) clini-
cal supervision as a supervisee with review of audio/visual recordings of ses-
sions; (c) clinical supervision as a supervisee reviewing challenging cases or
 Becoming Remarkable 367

cases with no improvement; (d) live supervision provided during sessions as

co-therapist; (e) focused learning in specific models of psychotherapy; (f)
reviewing recordings of therapy sessions with peers; (g) attending training work-
shops for specific models of therapy; (h) case discussions with a clinical supervi-
sor; and (i) discussions of psychotherapy related subjects with peers or mentors.
(Miller, Hubble, Chow, & Seidel, 2015, p. 121, items in parentheses added)

How have these ideas fared so far? Miller, writing in his personal blog (2015)
summarized the results.

Nearly three years have passed since I blogged about claims being made about
the impact of routine outcome monitoring (ROM) on the quality and outcome
of mental health services. While a small number of studies showed promise,
other results indicated that therapists did not learn from nor become more effec-
tive over time as a result of being exposed to ongoing feedback. Such findings
suggested that the focus on measures and monitoring might be misguided—or
at least a “dead end.”
Well, the verdict is: feedback is not enough to improve outcomes.

If feedback alone is not sufficient, what does Miller recommend? Later in the
same article he argues for the utility of “deep knowledge.”

What’s the best way to enhance the effectiveness of therapists? Studies on

expertise and expert performance document a single, underlying trait shared by
top performers across a variety of endeavors: deep domain-specific knowledge.
In short, the best know more, see more and, accordingly, are able to do more.

In the spirit of cultivating “deep knowledge,” another colleague of Miller,

Tony Rousmaniere, wrote a book, Deliberate Practice (2016). Rousmaniere,
like Chow, recommends a series of clinical practices to enhance therapeutic
abilities. For example, he offers the following example of an effective super-
vision session.

At the beginning of one video, Jon (the supervisor) noticed that the client came
into the session holding his stomach. I asked the client how he was feeling, and
he replied, “Oh, fine, maybe a bit sick, but I’m always like this. Probably some-
thing I ate. Let’s move on, I’ll get over it.”
Jon suggested that “the client’s nausea might be a sign that he actually started
the therapy session beyond his anxiety threshold before he even sat down in the
chair. He might be minimizing his anxiety with you due to obedient relational
patterns he had learned from his past attachment figures. But let’s watch some
more tape and see what happens.”
As predicted, the client’s nausea increased as the session progressed.
368 Chapter 15

“Nausea is a common sign that the client’s anxiety has gotten so high that it
has passed over the threshold into the parasympathetic nervous system. This can
cause a client to deteriorate in therapy. Although the client may try to comply
and follow you in session, proceeding while his anxiety is this high only rein-
forces the client’s habit of self-neglect. This is a relationship based on following
you rather than attending to himself. The client really wants to make progress
but is simply overwhelmed with cortisol [a stress hormone] from his anxiety.
What I recommend here is to pause and try to help the client downregulate his
anxiety.” (Rousmaniere, 2016, Kindle Locations 902–913, items in parentheses
added).

It’s hard to believe that this sort of excellent supervision has no impact yet, of
course, that is what the outcome literature suggests. Rousmaniere attempts to
get around this finding by cultivating an attitude of commitment and prioriti-
zation; essentially he suggests that therapists do all of the standard improve-
ment practices list by Chow more and harder. In addition, he particularly
recommends videotape review and solitary deliberate practice.
Would excellent supervision and extensive daily practice actually enhance
therapist competence and redress weaknesses? At the level recommended by
Rousmaniere, the likely answer is “yes.” Given that psychotherapy operates
in constructed reality, doing anything positive with firm intention—invest-
ing extensive amounts of time and focus—is likely to result in some sort of
improvement/accumulation of charisma.
The insight that psychotherapy occurs in constructed reality has the capac-
ity to enhance Miller’s model of deliberate practice. First, while Miller and
his colleagues have been explicit and unrelenting in their insistence that tech-
niques have no inherent power, it is not that easy to release those beliefs. For
example, examining the Chow list and the Rousmaniere supervision vignette,
it appears that the inherent power of techniques peeks through the overt focus
on the therapist. They cite practices such as reading journals—which are
technique based—and literally reviewing techniques as methods of deliber-
ate practice. Perhaps even more importantly, we should recall that Kahneman
argues that System 1 is the “hero” of his book; System 1 believes all reality
is fundamental and that clients get better because of techniques. Without a
specific appeal to the constructed reality paradigm, therapists will continually
fall under the spell of System 1 assumptions. And, as long as that occurs, all
the Chow and Rousmaniere recommendations—which are essentially the
same recommendations that have been present in the field for the last fifty
years—will continue to generate the same results: no meaningful improve-
ments. Truly accepting that psychology has no privileged knowledge—and
can never amass privileged knowledge because it operates in constructed
reality—is a shocking conclusion. Miller and his colleagues operate at the
edge of this conclusion but are hesitant about endorsing it fully.
 Becoming Remarkable 369

Second, it is difficult to identify weak points when psychotherapy operates

in constructed reality and there is a bias toward a modest, positive improve-
ment regardless of what is done. More specifically, we have competing
systems describing the psyche in various conflicting ways and prescribing
various incongruent approaches to remediate the problems. Once past the
“relationship with a wise and caring therapist,” one enters a chaotic and con-
tradictory no-man’s land. How can one know one’s specific weak points—and
apply deliberate practice—when techniques have no validity and when reality
changes from client to client, from moment to moment, and from therapist
to therapist. In other words, if all techniques are constructed and essentially
equivalent, and deliberate practice requires a benchmark of knowledge about
“what works,” then deliberate practice will have problems with effectiveness
in fields where there is a high degree of constructionism.
In an attempt to address this confusion, this book attempts to create a
“map” of constructed reality. Without such a map, it is impossible to perform
the assessment of strengths and weaknesses needed for deliberate practice.
This map of constructed reality essentially rests on dialectic principles. Some
of the primary organizing principles in use are: 1) wisdom versus compas-
sion, 2) the Net versus the Abyss, 3) Apollonian change versus Dionysian
change, 4) altered states versus ordinary consciousness, 5) authentic ultimate
concern versus idolatrous ultimate concern, 6) the chaotic Abyss versus the
oracular Abyss, 7) connected versus alienated/alone, 8) technique versus
ritual and 9) beginner’s mind versus expert mind. Because we are describing
constructed reality, there can never be a complete and comprehensive list of
all of its qualities. However, there can be a functional description which may
have utility. And, recalling the constructionist principle about truth, the ques-
tion is not “is it true?” rather, it always remains “is it useful?”
Since constructed reality allows so many choices and so many directions,
it can be helpful to oversimplify matters in order to facilitate discussion and
analysis. Each chapter in the clinical section makes its own contribution to
deliberate practice. The chapter on beginner’s mind emphasizes discernment
between fundamental reality and constructed reality. It is challenging to let
go of our default assumptions that we are always operating in fundamental
reality; more specifically, achieving the sense that what happens in the room
is a ritual, not a technique, is the basis for all progress in the evolutionary
model. This central principle runs throughout all the clinical chapters. It is not
accident that last clinical chapter on overtly spiritual approaches emphasizes
spiritual materialism. As was documented, the perennial philosophy repeat-
edly returns to a “kill-the-Buddha” perspective as even constructionist seek-
ers continually become entranced with techniques (e.g., meditation).
The vast majority of therapy sessions focus on Apollonian concerns and
every therapist is required to check whether she is comfortable being a
370 Chapter 15

representative of the culture, urging clients to achieve basic goals, and are
at ease with “right” and “wrong.” A number of therapists find it difficult to
don this “mantle of power” and resist such a role even when the client would
benefit from it. A related difficulty arises with the relatively frequent need
to help a hyperstabilized client move via organizing family and community
resources to “force” the client off of their frozen stance. And some therapists
are uncomfortable with the Apollonian insistence that the conscious mind
must control feelings and impulses.
While every therapist and every approach uses some form of dissociation,
this does not imply that all use dissociation equally effectively. Particularly,
the need to restabilize the client into some form of a pathologized label such
as “survivor” and “recovering addict” can be challenging. While such labels
do serve the interests of some clients, it is important to notice whether the
therapist’s need for Apollonian stability is trumping the needs of the client.
Most important in terms of the Apollonian approaches, of course, are the
Dionysian therapists who undervalue Apollonian foundations. Perhaps due
to some fear in their own life, they hesitate to embrace culturally validated
achievement and fail to emphasize secular success experiences. It is worth
remembering Buber’s admonition that one must have firm foundations in
culturally sanctioned achievement before launching into the Abyss. And
of course the Buddhist saying “Be someone before becoming no one” also
comes to mind.
The chapters on Heart and Soul—and the one on dissociation—mark the
beginning of Dionysian approaches. Feelings and shadow material always
threaten the primacy of the ego and traditional rational thought. Those thera-
pists who are challenged by the numinosity of the unconscious or who are
uncomfortable with powerful feelings might feel themselves pulling back
when attempting to master these approaches.
And if the early Dionysian chapters are threatening to some therapists,
the one on sacred space goes even further in that direction. Now, instead of
responding to breakthroughs of the Abyss in the form of feelings and psy-
chopathology, the therapist is enjoined to create and work with experiences
which lead to encounters with the Abyss. Being effective at something like
hypnosis requires “putting on the Shamanic robe” and assuming a role that
intertwines the identity of the therapist with the client’s experience of the
sacred. The quote from Gilligan about his experience of Erickson “holding
him” during his trance experience is representative. A number of therapists
might find threatening elements in that story.
The chapter on spiritual approaches details how difficult it can be to move
beyond the ongoing war between science and religion. While the path of wis-
dom—constructionism taken to a logical conclusion—faces little opposition
from the science/religion conflict, the perennial philosophy cautions that the
 Becoming Remarkable 371

ongoing effort to discern between the “real and the unreal” offers deep chal-
lenges to most practitioners. And the path of the heart, with its insistence that
gifted “connectors” not only say “thou” to the universe but also hear a “thou”
in response, runs into its own range of resistance. Finally, avoiding the perils
of spiritual materialism is challenging for virtually everyone.
Constructionism is essentially client centered in that every ritual includes
an explanation of the problem and a rationale for the healing that must be
endorsed by the client. One can go beyond this idea of alignment and sug-
gest that every healing ritual arises out of the client’s ultimate concern. This
requires an ability to discern the client’s “truth”; more importantly, it requires
an ability to surrender to the client’s ultimate concern. The level of other-
centeredness can also be challenging.
In sum, there are a great many ways in which our personal weak points
can be discovered and delineated using the principles that define constructed
reality. For those who would like further examples, Appendix A, “The Geog-
raphy of Constructed Reality,” attempts to explore this area in more detail.
This book has argued that therapist charisma is directly related to the
therapist’s alignment with her own ultimate concern. It has also argued that
the therapist must stand in her own ultimate concern to discern the client’s
ultimate concern. At the same time, we know that therapists occasionally
have their own “crisis of faith” where they lose touch with why they are doing
what they are doing.
In traditional psychology, this is relatively unimportant; when techniques
have power, then the inner state of the therapist is relatively unimportant. A
crisis of faith—loss of contact with one’s ultimate concern—is sometimes
ignored and sometimes seen as a sign of burnout or compassion fatigue. In
constructionism, however, it is much more serious. Without clear alignment
with one’s own ultimate concern there is a marked diminishment of charisma
and an equivalent loss of ability to intuit the client’s ultimate concern. From a
deliberate practice point of view, this loss of alignment with the ultimate con-
cern is the most serious weak point and must be addressed directly through
approaches such as therapy, retreat, or meaningful change of life choices.
In sum, the geography of constructed reality outlined in this book allows
therapists to identify their weak points and remediation strategies in ways that
are reminiscent of basketball players and cardiac surgeons. The evolution-
ary model already established the need to embrace and experience the full
range of therapies instead of specializing in only one. Deliberate practice
complements the evolutionary model by requiring therapists to identify their
unique weakness and how the weaknesses might play out when operating in
constructed reality.
Deliberate practice is hard work. It intentionally urges us to practice in
the area of our weaknesses—a practice that by its nature often feels foreign
372 Chapter 15

and uncomfortable. While this is certainly true, even a deliberate practice

program can be approached with a sense of ease.
Protestant Christianity offers a particular angle on this dilemma when it
argues that salvation is achieved through grace and not through good works
and personal effort. Constructionism believes that many, if not all, of our
personal obstacles are constructed—in essence made-up factors that have no
intrinsic power unless we imbue the obstacles with power. When embarking
on a path of self-improvement or enhancement of charisma it is vital to bring
along a sense of humor, a basic lightness, and a fundamental humbleness.
Martin Buber (2006) attempts to characterize this attitude in the following
quote:

You can rake the muck this way, rake the muck that way—it will always be
muck. Have I sinned or have I not sinned? In the time I am brooding over it, I
could be stringing pearls for the delight of Heaven. (p. 30)

PERSONAL DEVELOPMENT: ENHANCING

CHARISMA OUTSIDE THE ROOM

I change too quickly: my today refutes my yesterday. When I ascend I

often jump over steps, and no step forgives me that.
—Friedrich Nietzsche, Thus Spake Zarathustra (1896)

This book focuses primarily on what can be done inside the room to enhance
charisma. It is clear, however, that there are a great many things that can
be done outside the room that can also enhance charisma. Exploring those
possibilities in detail would require a book in its own right. In place of that,
this section explores a few basic ideas that point toward out-of-the-room
opportunities.
In some ways, discussing what can be done outside the room is rather an
imposition on personal freedom. As has been discussed in some detail above,
the standard psychological perspective is that “who I am” is my business; I
should be able to be effective as a therapist regardless of my personal life
choices. And, indeed, that is the assumption when one joins a profession with
access to privileged information. Regardless of how appealing this argument
might be, however, psychology is not a profession where “who am I” is unre-
lated to outcome.
In this sense, psychology is as much a vocation as a profession. The
dynamic tension between vocation and profession is explored in the follow-
ing quote from the perspective of philosophy, a related discipline.
 Becoming Remarkable 373

There is another layer to this story. The act of purification accompanying the cre-
ation of the modern research university was not just about differentiating realms
of knowledge. It was also about divorcing knowledge from virtue. Though it
seems foreign to us now, before purification the philosopher (and natural phi-
losopher) was assumed to be morally superior to other sorts of people. The 18th-
century thinker Joseph Priestley wrote “a Philosopher ought to be something
greater and better than another man.” Philosophy, understood as the love of
wisdom, was seen as a vocation, like the priesthood. It required significant moral
virtues (foremost among these were integrity and selflessness), and the pursuit
of wisdom in turn further inculcated those virtues. The study of philosophy
elevated those who pursued it. Knowing and being good were intimately linked.
It was widely understood that the point of philosophy was to become good rather
than simply to collect or produce knowledge. (Briggle & Frodeman, 2016)

Briggle and Frodeman are pointing out that the impact of modernism resulted
in divorcing the study of philosophy both from its influence on character and
from the requirement that personal virtue is necessary in order to master the
field. Applied to psychology, Briggle and Frodeman might argue that enhanc-
ing therapist outcomes requires putting cultivation of virtue at the center of
the process. It follows, therefore, that those who resist seeing psychology as
a vocation will be inhibited in terms of their ability to garner charisma. Con-
versely, equating experience in the room with an immersion in “sacred space”
opens the door for an enhancement of both virtue and charisma.
Preparing for a vocation is different than preparing for a profession.
Imagine that you are training yourself for an important position, perhaps
something like being a military leader, or the CEO of Google, or the presi-
dent. You would intentionally seek out experiences that you believe develop
your character—experiences that will generate respect from the individuals
you hope to lead. The therapist who wishes to achieve above-average results
needs to develop charisma that is roughly equivalent to the charisma required
for these sorts of positions. While those jobs may have higher status than
psychotherapy, the need to be respected by those you wish to influence is
highly similar.
In addition to formal education, what kinds of experiences might you
find valuable in preparation for your new position? Most likely you would
respond that you would seek experiences that would open your heart, bestow
wisdom, or develop your character. In addition, you would hope that these
experiences would leave a positive mark on you—that you would be per-
ceived as powerful and charismatic. The list of such experiences is readily
available; essentially they are the kinds of experiences that result in the
respect of other cultural members. Anything that might get one invited to
address the local Rotary club is such an experience. Adventurous activities
374 Chapter 15

like climbing mountains and skiing to the North Pole qualify, as do extended
service experiences like saving gorillas or reducing famine in Africa. Certain
experiences of enduring suffering qualify such as surviving many days on a
life raft at sea or enduring an unusual illness. Eliade would call these experi-
ences pilgrimages to sacred space.
It is worth recalling Mallory’s famous reason for climbing Everest:
“because it is there.” To many people, risking one’s life and enduring weeks
of suffering simply to stand at the highest spot on earth makes little sense and
Mallory’s “reason” for climbing fails to satisfy their curiosity. But Mallory,
and other adventurers who risk life and limb on overtly purposeless adven-
tures, are shy when it comes to articulating their actual reasons. It sounds
crazy to say, “I’m climbing Mt. Everest because I will ascend to ‘heaven’,
be rewarded with divine knowledge and be transformed by the experience.”
While this is rarely expressed so directly, our interest in listening to lectures
and reading books about the experience shows that a large percentage of cul-
tural members implicitly feel the “truth” of such statements. We believe that
certain experiences have the capacity to transform individuals profoundly and
we are fascinated by their “heroic” stories.
Pilgrimages to sacred space are one of the key opportunities to enhance
charisma. Clearly, such experiences are rituals—power experiences endorsed
both by other members of the culture and the individual who chooses them.
It would be rare for a president or a pope or a military leader to ascend to
their high status position without at least some of these experiences. The
therapist who aspires to superior outcomes has a similar need for this kind of
transformation.
The most obvious approach to out-of-the-room enhancement is personal
growth experiences such as therapy, retreats, mentoring, and spiritual prac-
tices. Similar to pilgrimages, high charisma individuals often have stories
documenting the positive effects of teachers and periods of intentional reflec-
tion and transformation. The previous chapter described the benefits of such
approaches but also noted the limitations; the section on spiritual material-
ism essentially focused on the fact that many experiences lead to improved
satisfaction and esteem without leading to enhanced charisma. The secret,
apparently, is to practice with a “kill-the-Buddha” attitude. To offer another
angle on that conclusion, examine the following Sufi story:

A scholar asked the great sage Afzal of Iskandariya: “What can you tell me of
Alim Azimi, your teacher, to whom you attribute qualities which have fashioned
you?”
Afzal answered: “His poetry intoxicated me, and his love of mankind suffused me,
and his self-sacrificing services elated me.”
The scholar said: “Such a man would indeed be able to fashion angels!”
 Becoming Remarkable 375

Afzal continued: “Those are the qualities which would have recommended Alim to
you. Now for the qualities which enabled him to help men transcend the ordinary:
Hazrat Alim Azimi made me irritated, which caused me to examine my irri-
tation, to trace its source. Alim Azimi made me angry, so that I could feel and
transform my anger. Alim Azimi allowed himself to be attacked, so that people
could see the bestiality of his attackers and not join with them. He showed us the
strange, so that the strange become common-place and we could realize what it
really is.” (Shah, 2016, p. 21)

As in the other spiritual materialism stories, the seeker is constantly reminded

not to see spiritual growth as a concrete process of techniques that inevitably
lead to the achievement of the spiritual goal. Recall that personal therapy
does not result in enhanced outcomes. The goal is to be different, not better.
Finally, reflect on the concept that while this kind of personal growth
requires an openness to the guidance of others, it also requires holding on to
one’s personal sense of self. Swami Vivekananda comments:

Be strong! . . . You talk of ghosts and devils. We are the living devils. The sign
of life is strength and growth. The sign of death is weakness. Whatever is weak,
avoid! It is death. If it is strength, go down into hell and get hold of it! There is
salvation only for the brave. None but the brave deserves the fair. None but the
bravest deserves salvation. (Vivekananda, 1964, The Gita III)

With this quote Vivekananda succeeds in embodying the fierceness of spirit

which is helpful when seeking charisma. Charisma is not for the faint of
heart. Fear is an expected companion on the journey; in fact, the presence of
some sort of fear marks a transformational opportunity. But surrendering to
fear destroys the possibility of charisma enhancement.
A third approach is less traditional and predictable than the first two.
Examine the following “parable” that novelist, Tom Robbins, uses to con-
clude one of his stories.

In a place out of doors, near forests and meadows, stands a jar of vinegar—the
emblem of life.
Confucius approaches the jar, dips his finger in and tastes the brew. “Sour,”
he says. “Nonetheless, I can see where it could be very useful in preparing
certain foods.”
Buddha come to the vinegar jar, dips in a finger and has a taste. “Bitter,” is
his comment. “It can cause suffering to the palate, and since suffering is to be
avoided, the stuff should be disposed of at once.”
The next to stick a finger in the vinegar is Jesus Christ. “Yuk,” says Jesus.
“It’s both bitter and sour. It’s not fit to drink. In order that no one else will have
to drink it, I will drink it all myself.”
376 Chapter 15

But now two people approach the jar, together, naked, hand in hand. The
man has a beard and woolly legs like a goat. His long tongue is slightly swollen
from some poetry he’s been reciting. The woman wears a cowgirl hat, a neck-
lace of feathers, a rosy complexion. Her tummy and tits bear the stretch marks
of motherhood; she carries a basket of mushroom and herbs. First the man and
then the woman sticks a thumb into the vinegar. She licks his thumb and he hers.
Initially they make a face, but almost immediately they break into wide grins.
“It’s sweet,” they chime.
“Swee-eet!” (Robbins, 1990, p. 380)

In this quote Robbins is contrasting traditional recommendations about life

philosophy with his Western, counter-culture version. Essentially he is pro-
posing that living life fully and deeply—diving into loving, feeling, express-
ing—is a path equivalent to older spiritual paths. His words participate in
Whitman/Emerson/Thoreau transcendentalist tradition. They line up with
the Campbell reference cited earlier that the greatest contribution of Western
culture was the development of the concept of romantic love. Finally, Rob-
bins’ ideas are endorsed by one of the primary images of Western religion:
the creation of New Jerusalem on earth. The East defines earthly existence as
Maya and Samsara which must be resolved through liberation and Samadhi.
Conversely, the West believes that the world can be redeemed; the image
of the Holy City implies that we can recreate the “garden of Eden” on earth
itself. In this sense, alignment with the elements of this redemption is, in
itself, a personal spiritual path and a potential ultimate concern.
More specifically, this suggests that conscious marriage, child rearing, cre-
ativity, and authenticity can be equivalent to meditation and selfless service.
The secret, of course, is not simply performing such activities but investing
them with significance. In constructed reality, everything can serve as a ritual
of transformation as long as it is invested with meaning by the therapist and
the client. In this sense, Robbins is arguing that the connected and passionate
life is as valid a path as the path of an ascetic monastic.
Robbins’ parables suggest that acquisition of charisma is not limited to
pilgrimages to sacred space and conscious personal development, it can also
occur through living deeply and passionately. Put another way, he is recom-
mending a different attitude toward the sacrality of the world. Living life
whole heartedly—cultivating healthy desire—and connecting to the natural
world deeply is as valid a path as selflessness, renunciation, and asceticism.
A final example of personal development is closely related to the concept
of dancing with the Abyss. Examine the following quote from Francis Harold
Cook:

Activities such as chanting, bowing, and sitting in zazen are not at all wasted,
even when done merely formally, for even this superficial encounter with the
 Becoming Remarkable 377

Dharma will have some wholesome outcome at a later time. However, it must
be said in the most unambiguous terms that this is not real Zen. To follow the
Dharma involves a complete reorientation of one’s life in such a way that one’s
activities are manifestations of, and are filled with, a deeper meaning. If it were
not otherwise, and merely sitting in zazen were enough, every frog in the pond
would be enlightened, as one Zen master said. Dōgen Zenji himself said that one
must practice Zen with the attitude of a person trying to extinguish a fire in his
hair. That is, Zen must be practiced with an attitude of single-minded urgency.
(Cook, 1999, p. 33)

At first glance, this is another “kill-the-Buddha”-type quote and, indeed, that

element is highlighted. But the quote also emphasizes the “reorientation of
one’s life” toward deeper meaning and having a feeling of “single-minded
urgency.” This sense that every moment offers an opportunity for conscious-
ness, and mindfulness is one of the essential principles of the perennial
philosophy.
More specifically, constructionism—fully embraced—opens the door to
a level of lightness and freedom, particularly in terms of handling the dis-
tressing aspects of daily life. Put another way, the one who is free from the
illusions and delusions of the Net can achieve a profound sense of freedom.
Barbara Held, in a book focusing on constructionism, psychotherapy, and
identity, compiled several quotes illustrating the correlations between con-
structionism, detachment, and freedom.

Consider these few exemplary quotations, in which liberation often takes the
form of reinventing one’s (ever malleable) “self” or “identity.”
The doors of therapeutic perception and possibility have been opened wide
by the recognition that we are actively constructing our mental realities rather
than simply uncovering or coping with an objective “truth.” (Hoyt, 1996, p. 1)
. . . People can (in therapy) be enabled to construct things from different
viewpoints, thus liberating them from the oppression of limiting narrative
beliefs and relieving the resulting pain. . . . (They) may come to transcend the
restraints imposed by their erstwhile reliance on a determinate set of mean-
ings. . . . For still others a stance toward meaning itself will evolve; one which
betokens that tolerance of uncertainty, that freeing of experience which comes
from acceptance of unbounded relativity of meaning.” (Gergen & Kaye, 1992,
p. 183)
. . . In addition to the rejection of totalizing explanations . . . postmodern
thought also rejects strongly deterministic and reductionistic theories. . . . Indi-
viduals are free to choose, adopt and change self-images according to shifting
life circumstances and needs. A multiplicity of images is increasingly available
to everyone. They are democratic in the sense that individual life circumstances
(e.g., race, class, age, etc.) provide less constraint on their adoption than in the
past. (Boumgardner & Rappoport, 1996, pp. 126, 128; Held, 2007, pp. 33–34)
378 Chapter 15

These quotations from Held embody the qualities of lightness, detachment,

and freedom implicit in fully understanding and accepting constructionism.
Since most, if not all, of the factors that define us are constructed and not
part of fundamental reality, each individual is free to reframe their dilemmas,
challenges, and even their basic identity in any direction they choose. All
the limitations can be experienced as ephemeral and fragile, with the least
touch of consciousness, they disappear. Paul Watzlawick, who was both a
constructionist and a systemic thinker, wrote a book with the title The Situa-
tion is Hopeless but not Serious. Watzlawick reports that his title is derived
from an old, central European saying and suggests that it embodies the kind
of freedom that is available to anyone who is awake and aware.
Returning to the Dalai Lama’s typology of wisdom and compassion, there
is a quote from the New Testament that parallels the freedom of construction-
ism from a heart-centered perspective. “For my yoke is easy and my burden
is light” (Matthew 11:30). Just as the primary choice in wisdom is real versus
constructed, the analogous choice in compassion is alone versus connected.
Choosing to see connections versus alienation is the “light and easy” choice.
We all fear that we are alone; we relax and release into the concept we are
connected.
Each moment of life allows a practice and a choice. Every breath includes
an implicit discernment involving identity, meaning, and presence. In this
sense, cultivating charisma is a daily practice with each life experience offer-
ing an opportunity for enhancement or constriction.

DANCING WITH THE ABYSS

The whole life is a succession of dreams. My ambition is to be a

conscious dreamer that is all.
—Swami Vivekananda, The Complete Works
of Swami Vivekananda (1907)

It should be clear that most therapeutic wizards and most superior therapists
attained their high level of functioning without ever thinking about the Net,
the Abyss, or social constructionism. They did not take part in the evolution-
ary model and, while they may have brought serious thought to addressing
their own strengths and weaknesses, it is also unlikely they ever formally
participated in deliberate practice. Some of them may have embarked on
their own personal pilgrimages and others almost certainly benefited from the
guidance of a mentor or a therapist but most of them developed their charisma
via an intense personal relationship with their own ultimate concern. As an
example, examine the following autobiographical segment from Stephen
 Becoming Remarkable 379

Madigan about his early exposure to narrative therapy. It seems that Madigan
had been invited to participate in an apprenticeship experience with his men-
tors, Michael and Cheryl White.

To say that I took this narrative therapy apprenticeship seriously would be an

understatement. For example, when observing therapy sessions with Michael
White and David Epston (I would participate in anywhere from six to seven
therapy sessions every day), I wrote down each and every therapeutic question
in a notebook. In the evenings, I would ask Michael and David (and others)
questions about all the narrative questions that they had asked that day—to get
what I suppose could be called a genealogy of each question. I would ask where
certain questions came from, the intent behind their use of a collapsed and
mashed up temporality (past, present, future), why a certain grammar of expres-
sion was used, what theory and author a particular question belonged to, what
other questions could have been asked but were not asked, and so on.
Every night of my narrative therapy apprenticeship in Australia and New
Zealand, and after everyone retired for the evening, I would categorize each
narrative therapy question we discussed into a specific grouping. I would clas-
sify questions into relative influence questions, future possibility questions,
experience of experience questions, and so on. I was fascinated with narrative
therapy’s unique grammar; the decentered positioning of the therapist; narrative
therapy’s commitment to social justice; and how narrative therapy organized
around appreciation, respect, and wonder. I would then speak each question into
a tape recorder and include an annotated bibliography for each one (nerd-like,
indeed). (Madigan, 2012, Kindle Locations 179–292)

Reading this selection exposes us to Madigan’s sense of the power and poten-
tiality of narrative therapy. The apprenticeship embodied a quality of passion
and presence that suggests that his studies had become a link to his ultimate
concern. When a system of psychology becomes a symbolic stand-in for
one’s ultimate concern, then an ultimate commitment to that system can cre-
ate an exceptional therapist. The ultimate concern has a special relationship
to the Abyss and the Source. When it breaks into the Net, it is experienced as
sacred and numinous. Hence, any practitioner who has truly made her system
into an ultimate concern lives in sacred space, is a denizen of sacred space,
and opens herself to channel something greater than her. For therapists who
feel that their system embodies ultimacy, each session is a numinous experi-
ence—each connection with a client is a mythic event. Ram Dass says: “Treat
everyone you meet like God in drag” (Dass, 2007, p. 13). Therapists who
experience their work and their system as ultimate are having some kind of
interaction with their higher power in every session.
David Brooks, the New York Times columnist, describes this same kind of
practice from a different angle.
380 Chapter 15

I suppose that people who live with passion start out with an especially intense
desire to complete themselves. We are the only animals who are naturally unfin-
ished. We have to bring ourselves to fulfillment, to integration and to coherence.
Some people are seized by this task with a fierce longing. Maybe they are
propelled by wounds that need urgent healing or by a fear of loneliness or frag-
mentation. Maybe they are driven by some glorious fantasy to make a mark on
the world. But they often have a fervent curiosity about their inner natures and
an unquenchable thirst to find some activity that they can pursue wholeheart-
edly, without reservation.
They construct themselves inwardly by expressing themselves outwardly.
Members of the clergy sometimes say they convert themselves from the pulpit.
By speaking out their faith, they make themselves faithful. People who live with
passion do that. By teaching or singing or writing or nursing or parenting they
bring coherence to the scattered impulses we are all born with inside. By doing
some outward activity they understand and define themselves. A life of passion
happens when an emotional nature meets a consuming vocation. (Brooks, 2015)

In this brief quote, Brooks is offering a summary of many of the themes cen-
tral to dancing with the Abyss. Charisma is only enhanced when one has an
“intense desire” and a “fierce longing” that requires a “wholehearted” dedi-
cation. Their inner transformation rests on the ability to express themselves
outwardly. It is a vocation, not a profession.
There are so many ways to enhance charisma. Seeing our work as a chan-
nel and an embodiment of the ultimate concern is certainly one. The evolu-
tionary path and deliberate practice are two others. The section on personal
development only briefly discussed some of the ways to gather charisma
outside the room: pilgrimages to sacred space, psychological and spiritual
practices, and becoming an embodiment of the Western concepts of progress,
romantic love, and being present in the redeemable world.
Dancing with the Abyss is another term for meditation in action. When
one is learning to meditate, formal sitting meditation is considered the best
practice. The eventual goal, however, is to have the same consciousness that
is embodied in sitting meditation run throughout one’s life. As an interme-
diate step, students are taught walking mediation where they continue their
meditation practice while moving. This is followed by simple tasks, such as
food preparation, again with the enjoinder to continue to meditate while act-
ing in the world. The most advanced practice is to have the same conscious-
ness as sitting meditation when one engages in conflict situations or intimate
relationships.
Dancing with the Abyss is the fourth approach to cultivate charisma. As we
have shown, it rests on the ability to work consciously and gracefully with the
ultimate concern. In addition it requires the ability to show up in all aspects
of life—in the room with clients and in the regular world—with an implicit
 Becoming Remarkable 381

awareness of the nature of constructed reality and the dance between the Net
and the Abyss. It means experiencing the terror and meaninglessness of the
Abyss intertwined with its oracular and numinous nature. It means staying
fluid and centered even as our System 1 mind urges us to become rigid and to
dash for safety. Essentially it requires the therapist to transfer the meditative
presence cultivated in the room into every aspect of life.
This, of course, is a goal shared by many spiritual paths. This sharing is
hardly surprising given that psychotherapy in constructed reality is simply
another path in universe of paths that form the perennial philosophy. And the
shared characteristic of all those paths is that they conclude with the recom-
mendation that the practitioner cultivate an inner consciousness that recog-
nizes what is constructed and what is real and the truth about separateness
versus connection. Thomas Merton tells us:

Life is this simple: we are living in a world that is absolutely transparent and the
divine is shining through it all the time. This is not just a nice story or a fable,
it is true. (Thomas Merton, as cited in Brach, 2004, p. 72)

Finally we return to the place where therapists are the most privileged: the
opportunity to be a witness and a participant in others’ lives, dilemmas, and
possibilities. Certainly, even though the research fails to support it, there
must be another “royal road”—a road especially open to those of us allowed
to be part of our clients’ story. The primary theme of this clinical section is
the paradoxical concept that therapy is performed to enhance the charisma
of the therapist—to contribute to her personal transformation. Whether one
concentrates on donning the robes of Apollonian power, or sensing the mes-
sage and guidance from pathologizing, shadow work, and numinous dreams,
or listening to that “still, small voice” that characterizes spiritual work, every
encounter in the room opens the door for therapist growth. Our opportunity
to serve others is the key opportunity for our own evolution.

ONLY A BREATH AWAY

Afoot and light-hearted I take to the open road, Healthy, free, the
world before me, The long brown path before me leading wherever
I choose. Henceforth I ask not good-fortune, I myself am good-
fortune.
—Walt Whitman, “Song of the Open Road” (1856)

This book began with the outcome research and its insistence that therapists
do not benefit from training and fail to improve over time. Most importantly,
382 Chapter 15

the research demonstrates that clients do not change due to the inherent power
of psychological techniques. Regardless of how convincing the research
results might be, it is very difficult to accept the full implications of the find-
ings. Those who can integrate this information have a significant edge on
those who continue in denial.
We have discussed this material from so many angles: beginner’s mind,
placebo, identity, dissociation, sacred space, constructionism, and break-
throughs of the Abyss. For now, however, simply return to the simple and
stark research results. Return to the argument that psychology, along with
related fields like leadership and education, is not a science. Science functions
in fundamental reality. Human satisfaction, happiness, disappointment, and
depression—these all function in constructed reality. Healers will always heal
in constructed reality. They will always use rituals and ritualistic change will
always have a magical, unpredictable, and indefinable quality.
Clinical practice seems predictable because everything works. But when
everything works, we really know nothing about the subject area. In funda-
mental reality something always works better and other things work worse.
Constructed reality is not like that.
We have experts—superior therapists who generate superior results. Our
attempts to distill their patterns come to naught. These studies are fruitless
because even the gifted healers fail to discern the patterns in their own work;
many of them lack conscious awareness of how they achieve their excep-
tional outcomes. They also find that everything that they do with clients
works. It’s just that when they do it, it works better. And in shifting our atten-
tion from looking for their “patterns” to looking at them and their charisma,
new pathways open.
Is this a dismal situation? Yes, when one is committed to imposing funda-
mental reality tools on constructed reality. But, in truth, it is the opposite of a
dismal situation. Knowing that the vast majority of suffering is in constructed
reality—and that reality only seems solid when it is actually fragile and
brittle—is the farthest thing from a dismal situation. There is always a sense
that Becker is right and death and chaos are always only a breath or a thought
away, but simultaneously the oracular Abyss and the sense of connection and
meaning are also only a breath away.
Healers will always study healing. We are all rightfully concerned—per-
haps even obsessed—with being better at what we do. The secret to becoming
better is to become different. All the “kill-the-Buddha” stories show the way.
Jiddu Krisnamurti comments:

I maintain that Truth is a pathless land, and you cannot approach it by any path
whatsoever, by any religion, by any sect. . . . The moment you follow someone
you cease to follow Truth. (as cited in Weeraperuma, 1996, p. 3)
 Becoming Remarkable 383

Throwing oneself into the Abyss—killing psychological science—seems like

an invitation to chaos. Yet the perennial philosophy assures us that such an
action is paradoxically the way forward. This requires a level of boldness.
Rumi comments:

Run from what’s comfortable. Forget safety. Live where you fear to live.
Destroy your reputation. Be notorious. I have tried prudent planning long
enough. From now on I’ll be mad.

For all the calls to be courageous and bold, the teachers are also ready to
be reassuring. Joseph Campbell recommends that the seeker should “Follow
your bliss and the universe will open doors where there were only walls”
(as cited in Espiritu, 2016, Hero’s Journey). This is essentially identical
to Rumi’s counsel to “Respond to every call that excites your spirit.” And
Krishnamurti—who so often is dour and full of warnings about the wrong
direction—says: “It is only when the mind is free from the old that it meets
everything anew, and in that there is joy” (as cited in Lutyens, 2005, p. 374).
Rumi reminds us of the centrality of the “different not better” maxim. Nor-
mal rules no longer apply. Mostly, though, he reassures us at last that in the
“senselessness” there is also joy and hidden order.

Beyond our ideas of right-doing and wrong-doing,

there is a field. I’ll meet you there.
When the soul lies down in that grass,
the world is too full to talk about.
Ideas, language, even the phrase “each other”
doesn’t make sense any more.

And his final advice is to move forward, even if there are no clear markers
to show the path.

Keep walking, though there’s no place to get to.

Don’t try to see through the distances.
That’s not for human beings. Move within,
But don’t move the way fear makes you move.

NOTE

1. This may be logical but it runs into the research finding that all schools of
therapy achieve equal results. More specifically, the evolutionary model is implicitly
hierarchical; it argues that the schools of psychology that are more Dionysian and
closer to the Abyss are more “evolved” than the more Apollonian schools. Dionysian
384 Chapter 15

practitioners should best Apollonian practitioners. But the equality of results requires
us to immediately dismiss simple ideas of better and worse. In this sense, the research
results appear to contradict the implicit assumptions of the evolutionary model.
Before accepting this simple conclusion, one must examine a number of con-
founding variables. First, there is a hidden assumption that those who practice from a
more Dionysian perspective have already mastered the Apollonian approaches that
exist further down the hierarchy. Brief reflection, however, suggests that this assump-
tion is often untrue. For example, how often does one hear critiques such as “Jungian
therapists are wonderful to talk to but they just aren’t that grounded with their clients.”
This quote suggests that some Jungians may have skipped the therapeutic basics per-
haps because they are personally uncomfortable with an Apollonian focus. More
specifically, it is easy to imagine a therapist who is gifted with hypnosis and yet
uneasy about telling an underemployed father that he will never be happy unless he
gets a better job.
Similarly, it is equally unfair to assume that overt Apollonians fail to include a
range of Dionysian responses in their work. For example, many CBT practitioners are
as comfortable with emotions as the Borofskys and as ready to discuss the meaning
of life as a devotee of Logotherapy and Victor Frankl. In fact, the process literature
repeatedly notes that many therapists who are allegedly from differing schools behave
in a similar manner in actual clinical practice.
Imagine trying to design a research study that could measure whether the evo-
lutionary model results in an enhancement of charisma. First one would need to find
Apollonian therapists who essentially rejected Dionysian approaches, not simply in
theory but in practice as well. Next one would need to locate Dionysian therapists who
have access to a full range of Apollonian skills as well as a deep connection to their
Dionysian perspective. No studies such as this have ever been conducted and, due to
the difficulty of operationalizing the factors discussed, it is unlikely that such studies
will ever be conducted.
My personal experience is that when I master a new way of encountering real-
ity, I am a bigger person and, by implication, my charisma is enhanced. We are all
aware that this intuition in itself fails to prove anything, especially when I feel
enhanced by lots of other factors in my therapeutic world—for example, my experi-
ence and training—and they fail to improve my outcomes.
Even with this justified caveat, it remains appropriate to argue for the efficacy
of the evolutionary model. When we reflect on our own mentors and teachers—people
we invest with charisma and see as key individuals—they seem to emanate the quali-
ties associated with the evolutionary model. They have lived more deeply, felt more
profoundly, have the ability to see from more perspectives, and embody the compas-
sion and acceptance that lets us know they have owned their own shadow material.
Anything that helps me feel like one of my own teachers is likely to be a valid source
of charisma enhancement. The secret, of course, is to ensure that my mastery of the
next model truly gives me the experiences I attribute to my mentors. And, if my expo-
sure to the unconscious, or my work with altered states, or anything else new to me
feels as if it has been a journey into sacred space, then I suspect it really has been.
 Chapter 16

The Way Forward

Now and then we had a hope that if we lived and were good, God
would permit us to be pirates.
—Mark Twain, Old Times on the Mississippi (1875)

In 1965, when I was on summer vacation with my family, I ran out of books
to read. I was so desperate that I decided to read a new book that my step-
mother had brought on the trip entitled Games People Play. This book pretty
much blew away my thirteen-year-old mind. For those readers unfamiliar
with this venerable work, Games People Play was a pop psychology book by
Eric Berne (1996) where he introduced the ideas of the ego, superego, and id
and then talked about stereotypic interactions—“games”—that could occur
when individuals neglected to operate from their “adult” ego state.
I believed that the book was written by an incredibly wise man who had
given me the ultimate map describing how human interactions really work.
I felt liberated and empowered, confident that with this new information I
could not only refrain from making interactional mistakes on my own part,
but would also be competent to understand the mistakes made by others. It
seemed to me as if I had been transported to a higher plane of knowledge that
would transform my life completely and permanently.
Of course, many years have passed since that first psychological book,
and I suspect that I have failed to sustain my identity as a neo Freudian, but I
still relish the memory of the freedom and empowerment implicit in Berne’s
“map.” Obviously, I’ve been equally excited by many subsequent maps since
then—a number of which I’ve incorporated into this book—but I guess that
none of these subsequent models can ever quite equal the excitement that
arose from my “first.” All joking aside, however, the sense of power and

385
386 Chapter 16

freedom implicit in an existential map is one of the great gifts available to

seekers with intellectual curiosity and the passion which can accompany that
sort of curiosity.
That said, maps run into an immediate problem. As mentioned earlier,
Alfred Korzybski coined the famous phrase: “The map is not the territory.”
He was a constructionist in that he argued that humans do not directly
encounter reality; rather, they make a representation or “map” of it within the
psyche. This map is constructed both culturally and individually and hence,
varies from person to person. In this sense, each person lives within their own
constructed reality and these “multiple universes” form limitations to com-
munication and agreement.
Constructionists laugh at maps while simultaneously respecting their use-
fulness. Maps bring to mind a relevant Nasrudin parable.

Nasrudin walked into a teahouse and announced, “The moon is more useful
than the sun.”
“Why?” he was asked.
“Because at night we need the light more.”
(as cited in Blenkiron, 2011, p. 43)

Korzybski essentially argues that since we cannot experience the “sun”

directly, the “moon” or map becomes more important. Since we cannot live
in the midst of the Abyss—except briefly in altered states—the Net is more
important than the absolute reality against which it is projected. Kahneman
tells us that System 1 is the “star” of his book and the Net and constructed
reality is the star of this one. As Nasrudin points out, we are night denizens
and therefore dependent on what we can grasp of the world by the limited
light we can get from a moon. We should, therefore, honor the moon while
never forgetting it is not the sun. Funny, paradoxical, sad, and true all in one
small story.
Constructionists remind us that maps are not judged as true or untrue but
rather as useful or useless. In addition, they caution us to always be aware of
their essential insubstantiality. Similarly, the material in this book needs to
be taken lightly—seen as one attempt to create a useful map of what therapy,
and enhanced therapist effectiveness, might look like from a constructionist
point of view.
In order to make this concept of mapping more concrete, let us compare
the Reality B model with some of the other major models reviewed in this
book. The Introduction stated that the purpose of this book was to recognize
that psychotherapy operates in constructed reality instead of fundamental
reality and to examine the implications of that shift for improving outcomes.
The first implication is that a helping profession must have a “place to stand”
 The Way Forward 387

if it is going to operate in constructed reality. Tillich’s concept of the ulti-

mate concern provides that foundation and simultaneously addresses issues
such as the source of charisma and equalizing hierarchy between clients and
therapists. A geography of constructed reality was proposed allowing for the
development of the evolutionary model and deliberate practice.
Now compare this Reality B model to existing models. Almost all extant
psychological models ignore the research implications about training, experi-
ence, and techniques; in addition, they fail to address whether psychotherapy
operates in constructed or fundamental reality. This twin level of ignorance
is primarily responsible for the failure of psychology to achieve significant
progress over the past century. More sophisticated psychological models,
such as Miller’s deliberate practice, embrace the research findings and have a
focus on enhancing the therapist; unfortunately their inability to address con-
structed versus fundamental reality leaves the long-term results of their work
in doubt. Conversely, narrative therapy is profoundly aligned with construc-
tionism but it fails to integrate the implications of the research. As a result,
it still develops and teaches techniques as if they are powerful and effective
thereby failing to fully develop the full implications of constructionism.
Buddhist psychology seems to be the most promising in theory. It is pro-
foundly aligned with constructionism and there are many references, such as
the quote from the last chapter about “killing Buddha,” that explicitly warn
practitioners about the fallibility of techniques. It has an evolutionary range
from the Apollonian foundations of the eightfold path through the most
Abyss-oriented sense of non self.
Unfortunately, when these ideas are translated into practice, most Bud-
dhist psychologists seem to be unaware of the limitations of techniques.
For example, at present perhaps the most comprehensive gathering of Bud-
dhist therapeutic thought is represented by the book Wisdom and Compassion
in Psychotherapy (2012). This book has over twenty chapters, each written by
experts in Buddhist psychology. None of the chapters mentions the research
results and, while there are a number of references to non self and ideas like
killing the Buddha, there are many, many more recommendations about
Buddhist techniques; moreover, there are repeated and clear implications that
learning and practicing these techniques will improve the therapist and are
responsible for client change. In sum, Buddhist psychology is there in theory
but in practice, it appears to suffer from the same shortcomings as narrative
therapy.
Clearly, what we now require are more models that integrate the full impli-
cations of both the research results and constructionism.
To all those readers who, like me, have read hundreds and hundreds of
psychological articles and books, what comes next might create a smile.
Virtually all of those articles end with the recommendation for additional
388 Chapter 16

research. Given that this book has portrayed the science of clinical psychol-
ogy as “barking up the wrong tree” with its assertion that more research will
eventually succeed in defining the nature of constructed reality, it is ironic to
recommend more of it. To be a bit more precise, what I am actually recom-
mending is not more research—although eventually that can be helpful in
certain ways—but more thought and more dialog.
It should be clear that we have barely begun to consider the implications
of the research and the interactions between psychology and constructionism.
What we need now are more thinkers who are interested in answering basic
questions such as the ones below.

1. What makes clinical psychology different from other professions where

experience, training, techniques, and systems enhance outcomes?
2. Why are reversals and losses so much more powerful than successes and
what does that mean for how people change?
3. How much of psychology is fundamental reality and how much is con-
structed reality and what are the implications for change and for enhancing
therapeutic outcome?
4. Why do even beginners regularly achieve the modest, positive effect with
clients?
5. In a constructed reality, without the ability to take refuge in reliable tech-
niques and systems, what is the source of healing and change?
6. What do therapy techniques look like when viewed from the perspective
of constructed reality?

This list of questions can be expanded and refined. What is important is that
the research results and the constructionist analysis of clinical psychology
have opened Pandora’s box for psychology. The names of the released dae-
mons are “meaninglessness,” “disrespect from other professions,” “inability
to justify our practices,” “need to completely revamp how we conceptualize
change,” and so on.
The daemon of Hope lies in understanding that psychology is not alone.
Virtually all other professions that concentrate on constructed reality are in
the exact same boat—law, political science, and organizational development
are good examples. Many professions—such as medicine, architecture, and
economics—have substantial aspects that are constructed and would benefit
from the same analyses as psychology. The implication is that if psychology
can work consciously with constructionism we can provide real leadership for
these other fields. Psychology has at least begun to integrate constructionism.
Moreover our research base allows us to reject the power of the technique
much more thoughtfully than anything, for example, in education or organi-
zational development.
 The Way Forward 389

Accepting that human culture and some of the most essential aspects of
human experience are constructed is a major blow to the empiricists and
scientific fundamentalists. The universe gets much more difficult to dissect,
predict, and control. At the same time, accepting the constructed nature of
culture and identity is the first step to becoming more helpful and effective.
Certainly we will never get anywhere if we keep insisting that all human
psychology—and related fields and professions—can be framed as funda-
mental reality. Rumi reminds us how challenging it can be to maintain this
consciousness.

The breezes at dawn have secrets to tell you

Don’t go back to sleep!
You must ask for what you really want.
Don’t go back to sleep!
People are going back and forth
across the doorsill where the two worlds touch,
The door is round and open
Don’t go back to sleep! (Barks, 1995, p. 37)

Let’s allow Nasrudin to have the final word.

Nasrudin was walking past a well, when he had the impulse to look into it. It
was night, and as he peered into the deep water, he saw the Moon’s reflection
there.
“I must save the Moon!” the Mulla thought. “Otherwise she will never wane,
and the fasting month of Ramadan will never come to an end,”
He found a rope, threw it in, and called down: “Hold tight; keep bright; suc-
cor is at hand!”
The rope caught in a rock inside the well, and Nasrudin heaved as hard as
he could. Straining back, he suddenly felt the rope give as it came loose, and
he was thrown on his back. As he lay there, panting, he saw the moon riding in
the sky above.
“Glad to be of service,” said Nasrudin. “Just as well I came along, wasn’t
it?” (Shah, 1971, p. 42)
 Appendix
The Geography of Constructed Reality

The attempt to represent the geography of constructed reality through a series

of figures is incongruous at best and absurd at worst. Since it is constructed,
by definition what lies below is only the imaginations of one particular person
in the context of one particular culture. It is not intended to be true; instead
there is some hope that it might be useful.
We are all denizens of the Net. As Net dwellers, we benefit from concrete
structures even as we understand their limitations. It is better to think of the
figures below as a kind of poem—a poem that takes the unusual form of a set
of figures. Poems are intended to be evocative, as are these figures. Taking
things too literally will inhibit their usefulness.
The figures are necessarily incomplete and inaccurate. Each theme is a
universe in its own right and resents being constrained by a particular box or
category. Is it true that CBT or Psychodynamic systems only operate in the
Apollonian confines of the Net? Of course not; even the most facile analysis
reveals they operate in other areas as well. But for the purpose of facilitating
a holistic understanding of the geography of constructed reality, certain liber-
ties have been taken.
Structurally, each figure has the same left hand column; this column
defines the Net-Abyss interaction. The other columns vary and should pri-
marily be understood as representations of the consciousness of the therapist.
A different writer would have arrived at a different typology. As you read
the one below, an improved typology may occur to you. That analysis and
those improvements are evocative; simply creating a dialog between my
vision and your sense of constructed reality is one of the primary points of
this appendix.
The differences between anxiety that is pre-Net, anxiety at the Net and
anxiety due to breakthroughs of the Abyss are important. Pre-Net anxiety and

391
392 Appendix

Table A.1 Psychotherapy, Identity, and Pathology

Psychotherapy Systems Self/Identity Psychopathology
The Chaotic Abyss: Mental hospitals, jails, Disorganized Severe
Unable to connect half way houses, Undifferentiated decompensation
to the Net in a ghettos, homeless such as autism,
functional role, too schizophrenia,
traumatized to join severe
the Net personality
disorders
The Nomological Reality therapy Unitary Self Trauma, anxiety,
Net: Operating CBT depression,
within the culture. Psychodynamic substance abuse,
Achieving life issues for
culturally endorsed example, marital
goals or job-related
issues
Abyss Breaks Through Shadow work Multiple Selves Anxiety and
the Net: old age, Depth psychology depression
illness, and death, Soul making with existential
reversals, attacks of features,
anomie existential grief,
anomie
Sacred Space: A Hypnosis Multiple Selves Personal growth
pilgrimage to the Somatic therapies
boundary between Depth psychology
the Net and the
Abyss
The Numinous Abyss: Transpersonal No Self Spiritual growth
Leap into the Psychotherapies Atman
depths

depression are related to the feeling that I have failed in my attempt to be a

human being. Net-related anxiety and depression are related to failures and
possible failures in terms of succeeding at culturally endorsed goals. Anxiety
and depression related to Abyss breakthroughs are more existential. They are
connected to meaning and purpose; they make us question our place in the
universe.
The three columns in Table A.2 are all related to therapist development.
There are no entries in the “chaotic Abyss” row because such individuals
cannot function as therapists.
Differentiating between a “personal unconscious” and the “collective
unconscious” is always a bit challenging. In this book, the personal uncon-
scious refers to everything that is not related to the Abyss and Abyss break-
throughs. This includes social programming, trauma, mislearnings, modeling,
etc. Feelings, perceptions, prejudices, and ingrained habits are all contained
 Appendix 393

Table A.2 Wisdom, Heart, and Development

Therapist out-of-room
Wisdom Heart Development
The Chaotic Abyss:
Unable to connect
to the Net in a
functional role, too
traumatized to join
the Net
The Nomological Expert on the Kindness, Successful life in terms
Net: Operating Culture. Willing ethics, and of professional
within the culture. to make strong compassion and personal
Achieving culturally Apollonian in “I-It” accomplishments;.
endorsed goals interventions relationships “responsible”
individual
Abyss Breaks Through Discernment Work Personal therapy and
the Net: old age, between what is effectively transformation
illness, and death, real and what is with experiences.
reversals. attacks of constructed. Sees affect and Discern between
anomie breakthroughs emotions conventional therapy
as numinous and Dionysian
communications therapy
Sacred Space: A Awareness of Cultivate Consciously create
pilgrimage to the hierophanies “I-Thou” pilgrimage
boundary between relationship experiences such
the Net and the as retreats and
Abyss adventures
The Numinous Abyss: Discernment Universe says Dancing with the
Leap into the depths includes kill-the- “Thou” in Abyss level of
Buddha level of return consciousness in
judgment and professional and
experience personal life

in the personal unconscious. Conversely, the collective unconscious gener-

ates material from the Other—the Abyss or the Source. The unconscious of
pre-Net individuals contains a lot of Abyss-related material; unfortunately it
is so dominated by terror that it is difficult to work with directly.
The groups column is both related to what kinds of groups are useful at that
state as well as what kinds of groups a therapist might choose to facilitate to
master that level. The ultimate concern column similarly has the dual relation-
ship of “what is appropriate at this level” and “what kind of client ultimate
concern should be facilitated.” Recalling that the therapist is asked to stand in
her own ultimate concern to discern and work with the client’s ultimate con-
cern is helpful. Finally, the Tillichian paradox of simultaneously hierarchical
and flat creates a background context for the ultimate concern column.
394 Appendix

Table A.3 Unconscious Mind, Groups, and the Ultimate Concern

Unconscious Mind Groups and Sangha Ultimate Concern
The Chaotic The terrifying Afraid of any group Frozen in terror
Abyss: Unable Abyss experience because
to connect to of feeling of ultimate
the Net in a alienation
functional role,
too traumatized
to join the Net
The Nomological Personal Joins any group that Focused on
Net: Operating Unconscious facilitates motivation achieving
within the or skills that lead success in an
culture. to Net-related ethical and
Achieving success connected
culturally manner
endorsed goals
Abyss Breaks Collective Works with groups that Interprets
Through the Unconscious manifest compassion pathology
Net: old age, and guidance and feelings
illness, and for breakthrough as numinous
death, reversals, challenges messages
attacks of
anomie
Sacred Space: A Collective Connects to groups that Attempts to create
pilgrimage to Unconscious support experiences experiences of
the boundary of the numinous the numinous
between the Net
and the Abyss
The Numinous Numinous Abyss Part of groups that focus Manifests the
Abyss: Leap into on kill-the-Buddha ultimate concern
the depths experience in each moment
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 Index
Abyss, 2, 9, 45, 48, 49, 52, 60, 61,
64, 101, 103, 111, 112, 117–22,
127, 128, 133, 135–37, 139, 155,
156, 192, 211, 213, 214, 220–22,
226–29, 231, 238, 242, 245–48,
252–55, 273, 275, 279, 285–90,
298, 300, 303, 307, 309, 312, 313,
316, 318–20, 322, 329, 335, 348,
361–64, 369, 370, 376, 378–83,
386, 391–94
Apollonian, 55, 56, 120, 121, 127, 128,
135–37, 144, 147, 153, 155–58,
161–64, 177, 184, 191, 192, 195–97,
199–205, 208, 209, 212–14, 217,
218, 220, 222, 223, 226–31, 242,
252, 253, 255, 258, 259, 261, 262,
264–66, 272, 273, 275, 286, 287,
300, 301, 303, 304, 310, 313, 318,
333, 335, 341, 361, 363, 369, 370,
381, 383, 384, 387, 391, 393
Borofsky, Antra, 240, 396
Borofskys, 241–43, 349, 384
Brach, Tara, 141, 142, 310, 311, 313,
381, 396
Buber, Martin, 109–13, 119, 213, 231,
244, 245, 253, 254, 312, 320, 331,
333, 358, 372, 396
Burger, David, 46, 139
405
Campbell, Joseph, 67, 246, 254,
255, 339, 349, 350, 376, 383,
396, 401
chaos, 2, 33, 37, 38, 51, 54, 61, 65, 69,
72, 73, 98, 100, 103, 111, 117, 119,
126, 127, 135, 276–78, 287, 312,
382, 383
charisma, 7, 8, 11, 60, 126, 128,
131–37, 151, 152, 168, 170, 172,
174, 177, 181, 183, 188, 208, 209,
228, 230, 239, 240, 245, 253, 255,
261, 266, 271, 286, 301, 306, 317,
319, 322, 341, 343–46, 348–52,
354–56, 360, 363–65, 368, 371–76,
378, 380–82, 384, 387
compassion, 7, 54, 80, 105, 133, 167,
178, 204, 218, 219, 230, 231, 234,
235, 238, 239, 241, 243, 244,
311–13, 317, 331, 338, 344–46,
348, 353, 371, 378, 387, 393, 394,
396, 398, 400–3
constructionism, 1, 2, 7, 9, 11, 12,
63, 65, 67, 68, 73, 82, 86–88,
99–101, 117, 122, 125, 127, 128,
136, 145, 169, 185–88, 217, 222,
223, 252, 254, 257, 298, 311,
313, 316, 319, 320, 328, 350, 353,
369–72, 377, 378, 382, 387,
388, 396
406
dancing with the abyss, 122, 137, 228,
316, 335, 376, 378, 380
deliberate practice, 136, 300, 365–69,
371, 372, 378, 380, 387, 401
Dionysian, 55, 119, 121, 128, 135–37,
151, 155, 164, 176, 181, 191, 192,
201, 203, 204, 209,
212–14, 217, 226, 231, 232, 242,
258, 261–63, 266, 268, 270, 273,
275, 286, 290,
298–301, 319, 363, 369, 370, 383,
384, 393
Eagleman, David, 82, 83, 85, 86, 88,
397
ego state, 212, 214–16, 248, 385
Ego-state, 403
Eliade, Mircea, 276–79, 293, 297, 299,
326, 338, 362, 374, 397
epiphanies, 45, 119, 134, 229, 254, 275,
300
Erickson, Milton, 134, 146, 154–56,
169–72, 177, 180, 182, 184, 212,
260, 261, 263, 289,
344–49, 370, 397, 398, 404
Ericksonian, 179, 182, 290, 398, 404,
405
faith, 10, 40, 69–71, 103–6, 108, 109,
111, 112, 114, 115, 122, 124, 127,
205, 239, 248, 303, 306, 312, 320,
322, 329, 330, 335, 338, 356, 371,
380, 403
Farrelly, Frank, 88, 89, 172, 174–78,
180, 184, 188, 193, 204, 209, 235,
300, 344, 349, 397
Frank, 5, 7, 12, 88, 122, 123, 126, 149,
153, 155, 172, 183, 204, 252, 268,
271, 315, 359, 397
geography, 43, 54, 121, 128, 135, 257,
277, 298, 303, 306, 361, 364, 371,
387, 391
Germer, C. K., 230, 235, 238, 396, 398,
400–3
Index
Gilligan, Stephen, 118, 182, 288–91,
347, 349, 370, 398
god, 45, 54, 55, 63, 69–73, 76, 98, 99,
105, 106, 114, 132, 164, 253, 254,
276, 277, 279, 280, 285, 305, 306,
309, 319, 321–24, 326–34, 337, 338,
340, 345, 348, 357, 360, 379, 385,
398, 400
Haley, Jaye, 38, 155, 184, 187, 346, 398
heart-centered, 236, 241, 244, 246, 378
hierophanies, 276, 277, 279, 285, 288,
289, 299, 393
Hillman, James, 61, 119, 218, 246, 254,
327, 329, 336, 337, 399
Huxley, Aldous, 12, 399
Kahneman, Daniel, 29–35, 37, 38, 69,
99, 127, 137, 236, 356, 368, 386, 399
kill-the-Buddha, 340, 341, 364, 369,
374, 377, 382, 393, 394
Kornfield, Jack, 85, 312, 313, 316, 399
Krishnamurti, J., 341, 383, 399, 400
Luckmann, T., 46, 53, 77–79, 81, 139,
201, 217, 265, 395
Madigan, Stephen, 74, 118, 263, 351,
379, 400
materialism, 335, 336, 339–41, 369,
371, 375, 403
Miller, Scott, 20–22, 28, 42, 181, 343,
365–68, 395, 397, 401–3
mindfulness, 22, 51, 52, 61, 136, 141,
142, 228, 239, 310, 311, 313, 317,
318, 377, 396, 398, 400–3
narrative, 1, 74, 118, 124, 125, 263,
266, 270, 351–55, 360, 377, 379,
387, 400
net, 117–22, 128, 133, 135–37, 139,
148, 155, 157, 163, 164, 167, 170,
177, 191, 192, 195, 205, 211, 226,
228, 229, 231, 242, 244, 245, 248,
253, 255, 257, 266, 268, 275, 279,
 Index
285–90, 299, 300, 303, 304, 309,
310, 312, 313, 318, 329, 341, 345,
348, 353, 362, 369, 377–79, 381,
386, 391–94
Net-Abyss, 135, 136, 360, 361, 391
Nietzsche, Friedrich, 1, 55, 68, 122,
126, 134, 151, 205, 214, 222, 245,
253, 343, 365, 372, 401
numinous, 110, 133, 135, 137, 156, 232,
242, 252, 279, 282, 298–301, 337,
343, 345, 346, 364, 379, 381, 392–94
oracular, 135, 137, 229, 231, 245, 249,
252–55, 279, 287, 290, 316, 362,
369, 381, 382
perennial philosophy, 12, 127, 254, 300,
307, 309, 319, 323, 348, 361, 369,
370, 381, 383, 399
pilgrimage, 280, 283, 286, 297, 392–94,
399
placebo, 24, 91, 92, 98, 124, 125, 150,
151, 163, 382
postmodernism, 49, 68, 99, 103, 350
prayer, 289, 291, 321, 323, 331–33
Ramakrishna, 52, 73, 240, 319, 329–31,
337, 338, 350, 395, 401, 403
religiosus, 105, 276, 277, 297
resistance, 121, 143–45, 158–60, 164,
182, 183, 187, 195, 200, 205, 244,
259, 261, 270, 271, 300, 303, 334,
363, 371
right-brain, 230, 233, 234, 236
right-brain-connected, 234
rituals, 128, 149, 150, 177, 184, 239,
252, 270, 272, 279, 283, 286, 292,
298, 306, 357, 359, 374, 382
407
sacred, 70, 126, 185, 192, 242, 245,
262, 263, 275–86, 289, 290, 292,
293, 297–300, 303, 306, 313, 326,
332, 334, 338, 345, 361–65, 370,
373, 374, 376, 379, 380, 382, 384,
392–94, 397
Schore, 32, 232–39, 242, 244,
344, 402
shamanic, 122, 123, 133, 149, 184, 349,
370
social constructionism, 1, 2, 7, 11, 63,
65, 68, 319, 378, 396
spirituality, 104, 112, 258, 290, 303–6,
332, 336, 339, 340, 361
spiritual materialism, 335, 336, 339–41,
369, 371, 375, 403
sub-personalities, 223, 327
Swami Vivekananda, 60, 81, 108, 167,
181, 233, 328, 331, 335, 348, 360,
375, 378, 403
trance, 9, 141, 147, 154, 169–72, 179,
181–83, 192, 212, 215, 242, 263,
290–94, 296, 297, 310, 311, 314,
344, 346, 364, 370, 398
Vivekananda, 60, 81, 108, 167, 181,
233, 328, 331, 335, 348, 349, 360,
375, 378, 403
Wampold, Bruce, 4, 19, 22, 23, 25, 40,
41, 123, 167, 395, 397, 403
Whitman, Walt, 129, 131, 211, 212,
217, 227, 229, 255, 376, 381
Zeig, J. K., 146, 170, 172, 344, 348,
398, 404
zen, 140, 339, 340, 377, 403
 About the Author

Stephen Bacon is a licensed clinical psychologist in private practice in Santa

Barbara, California. He has a long history of interest in how worldview struc-
tures an individual’s reality and how that interacts with the therapeutic rela-
tionship and the possibility of positive change and growth. In addition to his
formal psychology training, Dr. Bacon has a degree in the phenomenology of
religion, has lived in a meditation center for almost six years, and has written
a book on metaphors and archetypes in experiential/adventure-based educa-
tion. He has studied a variety of high impact therapeutic approaches such as
EMDR, NLP, hypnosis, and the Ericksonian model, and taught workshops
and retreats in the United States and Europe. In addition to his private prac-
tice of psychotherapy, he also works as a coach for nonprofit and corporate
executives and leaders. Outdoor adventure has also been a major motif in Dr.
Bacon’s life. He was vice president for program development for Outward
Bound after being a field instructor and fulfilled his personal commitment to
adventuring through blue water sailing, white water kayaking, canoeing and
rafting, climbing, and mountaineering and canyoneering.

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